Background: To explore the risk factors for early pregnancy loss and to study the relationship between early pregnancy loss and intrauterine adhesion (IUA) confirmed by hysteroscopy. Methods: A retrospective study was conducted on 226 early pregnancy loss and 51 early pregnancy patients who received medical management combined with hysteroscopy at a regional institution from March 2020 to February 2021. The uterine cavity’s shape was evaluated by hysteroscopy 6 hours after treatment with medicine. Risk factors included maternal age, gestational weeks, gravidity, parity, number of prior early pregnancy losses, number of prior induced abortions, mean sac diameter (MSD) and IUA. Results: Our results showed that the prevalence of IUA increased significantly in early pregnancy loss cases (31.42%) compared with early pregnancy cases (9.8%) (p 0.01). Multivariate logistic regression analysis showed that maternal age (odds ratio (OR): 1.195, 95% confidence interval (95% CI): 1.077–1.326), gestational weeks (OR: 2.919, 95% CI: 2.028–4.201) and IUA (OR: 8.631, 95% CI: 2.455–30.336) were positively associated with early pregnancy loss, while MSD (OR: 0.943, 95% CI: 0.899–0.990) and parity (OR: 0.194, 95% CI: 0.088–0.428) were inversely associated with early pregnancy loss. Conclusions: Maternal age, gestational weeks and, IUA were the risk factors for early pregnancy loss. Special attention is to be given to cases of combined IUA when managing early pregnancy loss.