Objective: To explore the value of transabdominal ultrasound joint transvaginal ultrasound in the diagnosis of gynecological acute abdomen. Methods: The gynecological acute abdomen patients 110 cases by clinical and pathological diagnosis through our hospital from January 2013 to June 2016, All of the patients used the transabdominal ultrasound joint transvaginal ultrasound examination, compare the ultrasound diagnosis with the clinical pathological diagnosis coincidence rate, and analyzes all kinds of ultrasonic imaging manifestation of gynecological acute abdomen. Results: The transabdominal ultrasound joint transvaginal ultrasound in the diagnosis of gynecological acute abdomen the coincidence rate of 97.27%(107/110), there was no statistically significant difference compared with the clinical pathologic results (P>0.05); Diagnosis of ectopic pregnancy the coincidence rate of 96.77%(30/31), diagnosis of intrauterine pregnancy abortion of 94.44%(17/18), diagnosis of Rupture of Ovarian Cyst coincidence rate of 93.33%(14/15), diagnosis of the acute pelvic inflammatory disease, ovarian tumors torsion, endometriosis and placental abruption the coincidence rate of were 100% (23/23, 10/10, 8/8, 23/23), there was no statistically significant difference compared with the clinical pathologic results (P>0.05). Conclusion: transabdominal ultrasound joint transvaginal ultrasound in the diagnosis of gynecological acute abdomen, the coincidence rate of high with clinical pathology results, it is a feasible solution.