Abstract: Objective To evaluate the effect of epidural analgesia using low-concentration local anesthetics on the short-term maternal and fetal outcomes of the women with nonreassuring fetal heart rate tracing in the second stage of labor. Methods 1179 pregnant women who had regular prenatal visit were recruited into the study. All participants were singleton term vaginal deliveries with cephalic presentation and had nonreassuring fetal heart rate tracing during the second stage of labor. After propensity score-matched analysis, 232 subjects with epidural analgesia were allocated into the analgesia group and 232 cases without epidural analgesia during labor were assigned into the non-analgesia group. The short-term maternal and fetal outcomes were statistically compared between two groups. Results In the analgesia group, the incidence rates of forceps delivery, neonatal admission and umbilical cord blood pH < 7.2 were 51.3%, 13.8% and 53.4%, respectively, and the length of maternal hospitalization stay was 3.40 d, which were all significantly higher than those in the non-analgesia group （all P < 0.05）. However, the episiotomy rate, postpartum hemorrhage, severe perineal laceration, poor perineal wound healing, meconium-stained amniotic fluid, neonatal asphyxia, neonatal umbilical cord blood pH < 7.0 and neonatal morbidities including pneumonia, respiratory distress syndrome and hypoxic ischemic encephalopathy did not significantly differ between two groups （all P > 0.05）. The neonatal intensive care unit （ICU） admission rate also did not significantly differ between two groups （P > 0.05）. The distributions of four types of nonreassuring fetal heart rate tracing in the second stage of labor including recurrent early deceleration, recurrent variable deceleration, tachycardia and prolonged deceleration did not significantly differ between two groups （all P > 0.05）. Logistic regression analysis showed that epidural analgesia significantly increased the risk of forceps delivery and neonatal umbilical blood pH < 7.2 in pregnant women with nonreassuring fetal heart rate tracing during the second stage of labor （OR = 2.412 and 1.733, both P < 0.05）, whereas did not increase the risk of neonatal asphyxia （P > 0.05）. Conclusion Epidural analgesia does not increase the risk of severe maternal and neonatal outcomes if active managements are implemented when nonreassuring fetal heart rate tracing occurs in the second stage of labor.