Myometrial echogenicity is a description of the image characteristics seen during an ultrasound examination of the uterus. A normal uterine fundus should have a uniform echogenicity on ultrasound. When various organic diseases of the uterus occur, the texture of the uterine base is altered and the echogenicity is uneven on ultrasound, commonly seen in diseases such as fibroids and adenomyosis. It may appear as a markedly enhanced or markedly attenuated abnormal echogenicity in the normal myometrium, and the border may or may not be clear. It may protrude outside the uterine contour, or it may protrude into the uterine cavity or be confined within the myometrium. When abnormal echogenicity of uterine parenchyma is detected by ultrasonography, a comprehensive analysis is needed in combination with the patient’s clinical symptoms and other examination findings to make a clear diagnosis and active treatment.