Uneven echo of the muscle wall mainly means that the myometrium has developed substantial lesions, which may be caused by uterine fibroids, adenomyosis, endometrial cancer and other reasons. 1. Uterine fibroid: it is a benign tumor formed by proliferation of uterine smooth muscle tissues, which may be caused by genetic factors, abnormal sex hormone level, stem cell mutation and other reasons. Due to the appearance of tumors in the myometrium, the phenomenon of uneven echogenicity of the muscle wall may appear when doing examination. 2. Adenomyosis: It refers to the appearance of endometrial glands and mesenchyme in the myometrium, and about 15% of them are combined with endometriosis at the same time. It may be caused by uterine surgery, labor and delivery, etc. Uneven echogenicity of myometrium will be found during ultrasound examination. 3. Endometrial cancer: the cause is still unclear, and its occurrence may be related to hormone level, heredity and other reasons. Malignant tumor of endometrium invades into the myometrium, which results in the phenomenon of uneven echogenicity of myometrium wall. Patients with myometrial echogenicity should go to the hospital and follow the doctor’s instructions to avoid delaying their condition.