【Abstract】 Objective To explore the significance of ultrasound typing in the selection of clinical semen extraction methods in patients with congenital bilateral absence of vas deferens (CBAVD). Methods The clinical data of 97 patients with CBAVD in Suzhou Hospital Affiliated to Nanjing Medical University were analyzed retrospectively. All patients were treated with clinical physical examination, semen analysis, serum sex hormone level, CFTR gene △ F508 mutation site, scrotal and transrectal ultrasound, bilateral kidney ultrasound and ICSI. Results 97 cases of CBAVD patients showed different locations of the absence of vas deferens by scrotal and transrectal ultrasonography. According to whether the structure of epididymis is complete, the patients can be divided into two types of CBAVD with intact epididymis and CBAVD with incomplete epididymis. The CBAVD with incomplete epididymis can be divided into four subtypes, namely, the absence of both epididymis, the absence of both epididymis and tail, and the absence of both epididymis One side epididymal body and tail are absent. According to different types of ultrasound, select the appropriate puncture and semen extraction, and take the transvaginal ultrasound examination after ICSI treatment to show the pulsation of gestational sac and heart tube as the clinical pregnancy standard. There was no significant difference in the clinical pregnancy rate after puncture and semen extraction in patients with different types of ultrasound (P＞0.05). There was no significant difference in the clinical pregnancy rate between the patients with PESA and the patients with Tessa after ICSI (P＞0.05). Conclusion The ultrasonic classification of CBAVD shows the specific location of the absence of the vas deferens, which provides the basis for the selection of appropriate puncture and semen extraction before ICSI treatment, and avoids the pain of patients caused by unnecessary clinical operation. There was no significant difference in the clinical pregnancy rate after ICSI treatment in different types of CBAVD patients.