Objective: To develop and validate a concise risk scoring tool for predicting postpartum hemorrhage (PPH) in women with scarred uteri undergoing forceps-assisted delivery in a subsequent pregnancy.Methods: A total of 120 women with a scarred uterus who were again pregnant, delivered at our hospital between January and December 2024, and underwent forceps-assisted delivery were prospectively enrolled as the study population. Participants were divided into two groups based on the occurrence of PPH: 47 in the hemorrhage group and 73 in the non-hemorrhage group. Univariate analysis was used to identify potential risk factors. Multivariate logistic regression was then applied to determine independent predictors of PPH and to construct a simplified risk scoring tool. The diagnostic performance of the tool was evaluated using ROC curve analysis.Results:Significant between-group differences (P < 0.05) were observed in maternal age, pre-pregnancy BMI, gravidity, gestational age at delivery, uterine scar thickness, inter-pregnancy interval, history of curettage or uterine surgery, neonatal birth weight, gestational hypertension, gestational diabetes, placental abruption, placenta accreta/increta, soft birth canal injury, and prenatal levels of fibrinogen (Fbg), activated partial thromboplastin time (APTT), international normalized ratio (INR), prothrombin time (PT), and hemoglobin (Hb). Multivariate logistic regression identified neonatal birth weight, gestational hypertension, gestational diabetes, placental abruption, placenta accreta/increta, soft birth canal injury, and prenatal Fbg and Hb levels as independent predictors of PPH (P < 0.05). These variables were incorporated into a rapid assessment scoring tool. ROC analysis yielded an AUC of 0.862 (95 % CI: 0.775–0.948, P < 0.05), indicating good predictive accuracy.Conclusion: The newly developed risk scoring tool demonstrates strong predictive performance for PPH in women with scarred uteri undergoing forceps-assisted delivery. It can serve as an effective clinical instrument to identify high-risk parturients and guide preventive strategies against postpartum hemorrhage.