Transvaginal ultrasound is the preferred imaging method for the diagnosis of adenomyosis.The ultrasonographic features of adenomyosis are closely related to its histopathological features.The main sonographic features include spherical enlargement of uterus，asymmetric thickening of anterior and posterior walls，uneven echo of myometrium，linear streaks or island nodules under endometrium，unclear demarcation of endometrium-myometrium，thickening，irregular or interrupted junction zone （JZ），fence-like shadow，intramyometrial cysts，CDFI showing increased blood flow signals in the affected area of myometrium，translesional vascularity and so on.Advanced ultrasound technology，such as cline clips and three-dimensional ultrasound，can complement the shortcomings of conventional ultrasound and improve the diagnostic efficacy of ultrasound for adenomyosis.