The study established a classification system for cesarean pregnancy (CSP) based on magnetic resonance imaging (MRI) in 98 women, who were divided into three types according to vascular characteristics and myometrial scar thickness. Type I (35 patients) had simple cystic sacs with minimal vascularity, type II (35 patients) moderate vascularity and mixed cystic-solid features, type III (28 patients) large mixed cysts with prominent vascular cavities, pools and arteriovenous fistulas. Median intraoperative blood loss was 20 mL for type I, 50 mL for type II, and 265 mL for type III (p < 0.001). Type III was the strongest independent predictor of bleeding according to multiple linear regression (β = 327.2, p < 0.001). Preoperative uterine artery embolization (UAE) significantly reduced blood loss in patients with type III (p < 0.001) but did not show benefit in types I and II due to limited data. MRI classification allows bleeding risk stratification and supports individualized management of CSP.