Objective To explore the clinical application value of magnetic resonance imaging (MRI) in the diagnosis and classifications of congenital uterine malformations.Methods A total of 287 patients with suspected congenital uterine malformation were enrolled as the research objects from July 2016 to February 2022. All underwent ultrasound and MRI examinations. Taking hysteroscopy results as the golden standard, the diagnostic value and efficiency of MRI and ultrasound for congenital uterine malformations were analyzed. The diagnostic accuracy rates of the two methods for different types of congenital uterine malformations were compared. Results Hysteroscopy showed that in the 287 patients, there were 239 cases with congenital uterine malformations, including 9 cases with non-development or hypoplastic uterus, 38 cases with unicornuate uterus and rudimentary horn uterus cavity, 53 cases with uterus duplex, 21 cases with bicornuate uterus, 111 cases with mediastinal uterus, 5 cases with arcuate uterus and 2 cases with tubular uterus. The consistency between MRI and hysteroscopy (Kappa=0.746) was greater than that between ultrasound and hysteroscopy (Kappa=0.574). AUC of MRI in the diagnosis of congenital uterine malformations was greater than that of ultrasound, and diagnostic accuracy rate was higher than that of ultrasound (P<0.05). The diagnostic accuracy of MRI for mediastinal uterus was higher than that of ultrasound (P<0.05). Conclusion MRI is of diagnostic value for congenital uterine malformations, and its diagnostic accuracy rate for mediastinal uterus is higher