Objective To Analyze the clinical features of lower genital tract masses in young girls, predict the diagnostic efficacy of Doppler ultrasound in related diseases, compare its advantages and disadvantages with CT, MRI and other imaging methods and guide clinical relevant diagnosis and treatment strategies. Methods A retrospective analysis was performed on 39 adolescent patients with lower reproductive masses diagnosed and treated in West China Second Hospital of Sichuan University from March 2010 to May 2021. Disease types, related clinical features, ultrasonic manifestations, postoperative records and pathological data of 39 cases of lower reproductive tract mass in young female were collected. The coincidence rate with clinical diagnosis were analyzed, and to explore the diagnostic value of ultrasonography in the abnormal development of lower reproductive tract in young girls. Results Of the 39 genital tract masses, 10 cases were of malignancy (two originating from the uterus and eight originating from the cervix), 2 patients were of benign lesions (both of vulvar origin). There ertr 27 cases due to developmental abnormalities were found in 39 cases of the lower genital tract (15 cases of oblique vaginal septum syndrome, 6 cases of vaginal atresia, 2 cases of hymenal atresia, one case of the transverse vaginal septum, one case of congenital absence of the vagina, and 2 cases of epiglottic duct cyst). Conclusion For lower genital tract tumors, ultrasound can be used to evaluate the benign and malignant mass by mass size, nature, blood flow signal and other parameters. It is significant in basic physical examination, general survey and clinical follow-up, and can also guide related clinical strategies