Endometrial echogenicity with high echogenicity has many causes, which may be caused by physiological factors, or it may be related to endometrial polyps, submucosal fibroids and other diseases. 1. Physiological factors: when women do ultrasound in the pre-menstrual period, the estrogen in the body is high, and the phenomenon of endometrial hyperplasia and thickening will occur, and the results of the examination may show that the endometrium has uneven echoes, accompanied by high echoes, and can be rechecked one week after the end of menstruation. 2. Disease factors: (1) endometrial polyps: a common endometrial lesion, mostly associated with hormonal secretion abnormalities or inflammatory stimuli, accompanied by menstrual dribbling, prolonged menstruation, lower abdominal pain and other symptoms, ultrasonography can be found in the endometrium echogenic unevenness, accompanied by high echogenicity. (2) Uterine submucous fibroid: caused by local estrogen increase, the surface of fibroid is covered by endometrium, in ultrasonography may appear endometrial echogenicity is uneven, accompanied by high echo, mostly accompanied by symptoms such as increased menstrual flow, prolonged menstruation, and leucorrhea. In addition to the above reasons, incomplete abortion, endometritis, etc., can also lead to uneven endometrial echogenicity with hypoechoicity. It is recommended to consult a doctor in a timely manner, complete the relevant examinations, and clarify the cause of the disease under the guidance of a professional doctor, so as to provide targeted treatment.