The decision of whether a cervical cerclage at 22 weeks with a cervical length of 1.6 cm can be done or is needed needs to be made in the context of the specific history. Cervical insufficiency refers to pathologic laxity and dilatation of the cervix in the mid-pregnancy and delivery states, which cannot maintain the progress of pregnancy. Typical clinical manifestations are shortening and even dilatation of the cervical canal without contractions in the middle and late stages of pregnancy, accompanied by bulging membranes, followed by premature rupture of membranes and premature delivery of the immature fetus, which is an important cause of fetal loss. Currently, there is no standardized criteria for the diagnosis of cervical insufficiency. A cervical canal length of 1.6 cm at 22 weeks’ gestation, less than 2.5 cm, and a lack of a previous history of mid-pregnancy fetal loss do not fully diagnose cervical insufficiency, which can be monitored closely with dynamic repeat ultrasound. According to guideline recommendations, women with singleton pregnancies who have a history of one or more mid- to late-term pregnancy miscarriages or preterm labor should undergo cervical cerclage if ultrasound suggests a cervical length of ≤2.5 cm by 24 weeks’ gestation. Whether or not to circumcise the cervix at 22 weeks with a cervical length of 1.6cm is up to the doctor to weigh the pros and cons according to the specific situation and formulate an individualized diagnosis and treatment plan in order to avoid adverse consequences.