There are more reasons for uneven endometrial echogenicity during ultrasound examination, which may be benign lesions, such as endometrial polyps, endometritis, etc., or malignant lesions, such as endometrial cancer. 1. Endometrial polyp: endometrial polyp may be related to high estrogen level in the body or chronic endometrial inflammation, which may easily lead to intermenstrual bleeding and prolonged menstruation, which is a kind of benign lesion. 2. Endometritis: endometritis is one of the pelvic inflammatory diseases, and the typical symptoms are increased secretion, abdominal pain, lumbago and even fever. 3. Endometrial cancer: endometrial cancer is one of the three major malignant tumors of female reproductive tract, which may easily cause increased menstrual flow, prolonged menstrual period, or irregular vaginal bleeding after menopause. There may be other reasons for uneven endometrial echogenicity during ultrasound examination, so it is recommended to consult a doctor in time, complete the relevant examination, clarify the cause of the disease under the guidance of a professional doctor, and target treatment.