Uneven echo in the myometrium of the posterior wall of the uterus is a kind of ultrasound term, most commonly seen in uterine fibroids, adenomyosis and other diseases, it is recommended to consult the doctor in time, and follow the doctor’s instructions to improve further examination. 1. Uterine fibroids: they are common benign tumors in gynecology, and they often present with abnormal menstruation such as increased menstrual flow and prolonged menstrual period, increased vaginal discharge such as leucorrhoea and purulent leucorrhoea, and discomfort in the lower abdomen such as cramps and pain, etc. During ultrasound examination, the myometrial layer of the posterior wall of the uterus may appear to have unequal echoes due to fibroid tumors. 2. Adenomyosis: the cause is still unclear, mostly due to multiple deliveries, abortion and other factors leading to the growth of basal endometrial invasion into the myometrium, ultrasound examination, the myometrium of the posterior wall of the uterus can be found to have uneven echogenicity, the clinical manifestations of menstrual flow, prolonged menstruation, and gradually aggravated menstrual cramps, and may be accompanied by loss of libido. In addition, there are other causes of uneven echogenicity of the myometrium of the posterior wall of the uterus, and it is recommended to consult a doctor in time to find out the cause of the disease and receive treatment as soon as possible.