A refractory miscarriage is an unavoidable miscarriage that occurs during fetal preservation and usually develops from a preterm miscarriage. Unavoidable miscarriage is associated with more vaginal bleeding, more intense paroxysmal abdominal pain, and may be accompanied by rupture of the fetal membranes than a normal miscarriage. The usual findings are dilatation of the cervical os with obstruction of embryonic tissue or a bulging amniotic sac. If the size of the uterus is consistent with the number of weeks of menopause or is small, it indicates that the miscarriage has reached an inevitable stage and is diagnosed as a refractory miscarriage. Refractory miscarriage can be caused by embryonic abortion, abnormal number of chromosomes or structural abnormalities of the embryo; serious maternal comorbidities such as severe anemia, chronic diseases and heart failure can affect the development of the fetus and cause refractory miscarriage; serious reproductive tract infections and cervical insufficiency can also cause refractory miscarriage. Therefore, couples should undergo physical examination before conception to reduce the incidence of inevitable miscarriage. Also, relevant examinations should be actively improved during pregnancy to avoid miscarriage due to fetal dysplasia. If inevitable miscarriage has already occurred, the embryo and placental tissue should be expelled as soon as possible to avoid intrauterine infections, and if necessary, treatment should be performed with uterine evacuation surgery.