Endometrial punctate echoes may be caused by endometrial calcification, endometrial polyps, fibroids or malignant endometrial lesions. 1. Endometrial calcification: endometrial calcification may be caused by endometrial tissue necrosis and deformation resulting in calcification due to endometrial inflammation, post-abortion uterine cavity residue and so on. Calcification foci are often manifested as endometrial point-like strong echoes. 2. Endometrial polyps: endometrial polyps for inflammatory endometrial part of the blood vessels and connective tissue hyperplasia produced polypoid organisms protruding into the uterine cavity caused by the texture of the endometrial polyp, so the endometrial polyp makes its performance for the endometrium punctiform echogenicity. 3. Uterine fibroids: one type of fibroids is submucosal fibroids, which mainly protrude into the uterine cavity, while fibroids may undergo calcification, which may be manifested as endometrial punctiform echogenicity. 4. Endometrial malignant lesions: when endometrial malignant lesions occur, the endometrium is unevenly thickened, fish-like tissue mixed with abundant abnormal blood flow signals, and endometrial punctate echogenicity will occur. Many gynecological diseases may cause endometrial punctate echogenicity, therefore, when problems occur, we should consult the hospital in a timely manner, evaluate the clinical symptoms and formulate further treatment plans.