The uterus is located in the middle of the pelvis, with the bladder in front and the rectum behind. The anterior wall of the uterus refers to the wall of the uterus in front of the uterus, while the posterior wall of the uterus refers to the wall of the uterus behind the uterus. The anterior wall of the uterus and the posterior wall of the uterus are the same in terms of tissue structure and function, and there is no difference in essence, they are both the myometrium, only the location is different. However, the posterior wall of the uterus is more susceptible to lesions such as myometriosis or uterine adhesions than the anterior wall of the uterus. Myometriosis can occur in the posterior wall of the uterus as a limited thickening with significant clinical symptoms, such as dysmenorrhea and excessive menstrual flow, which can affect fertility and even cause infertility. In case of mild myometriosis, no treatment is needed. The posterior wall of the uterus may form adhesions with the rectum or pelvic wall tissues, manifesting as a posterior tilting of the uterus with poor peripheral boundaries. After a woman’s pregnancy, whether the placenta is located in the anterior wall of the uterus or the posterior wall of the uterus, etc., it is in a normal position and there is no good or bad difference. However, if the placenta is low and close to the cervical opening, it is considered to be hypoplastic or placenta praevia and needs to be closely observed.