Objective To explore the clinical value of threedimensional transvaginal ultrasound in the diagnosis of uterine anomalies.Methods 75 patients with uterine anomalies diagnosed by hysteroscopy and/or laparoscopy in the gynecologicaldepartment from April 2014 to November 2017 were adopted. The preoperative characteristics of twodimensionaltransvaginal ultrasound and thredimensional transvaginal ultrasound were analyzed retrospectively. The diagnostic value of twodimensional transvaginal ultrasound and threedimensional transvaginal ultrasound in uterine malformations were compared. Results There were 52 patients of uterine anomalies diagnosed by twodimensional transvaginal ultrasound with accuracy rate 69.3%（52/75）, and 71 patients diagnosed by threedimensional transvaginal ultrasound with accuracy rate94.7%(71/75). The difference was statistically significant (P＜0.05).Conclusion Thredimensional transvaginal ultrasound can observe the shape and structure of uterus, show the changes of endometrium morphology clearly and quantify the degree of uterine loss. There were advantages of simple, noninvasive and high repeatability. It is the first reliable examination for clinical diagnosis of uterine malformations.