Objectives Four-dimensional hysterosalpingo-contrast sonography（4D-HyCoSy) was used to evaluate the ipsilateral tubal patency after tubal pregnancy for providing the basis for clinical treatment. Methods There were 135 cases of tubal pregnancy after treatment were grouped basing on different tubal pregnancy treatment, including drug conservative treatment group (40 cases), laparoscopic tubal incision and embryo group(38 cases), laparoscopic partial tubal resection and anastomosis group(25 cases) and laparoscopic salpingectomy group(32 cases). The patency of tubal patency between groups was observed by contrast diagnosis of 4D-HyCoSy. Results Drug conservative treatment group ipsilateral tubal patency 4（10%）,pass and poor 20（50.0%）, blocking 16（40.0%）; laparoscopic tubal incision to take the epidermis of the ipsilateral tubal patency 9(23.7%), pass and poor 20(52.6%), blocking 9（23.7%）; Laparoscopic partial fallopian tube resection of the anastomosis of the ipsilateral tubal patency 2 (8.0%), pass and poor 14(48.0%), blocking 9 (44.0%); Between the three groups, the tubal patency rate was compared between two, the difference was significant（P<0.05）by comparing the conservative treatment group and laparoscopic incision group; There was no significant difference between the conservative treatment group and the laparoscopic partial tubal resection(P> 0.05); There was no significant difference between laparoscopic incision group and laparoscopic partial salpingectomy group(P> 0.05); Thirty-one of the 135 patients underwent tubal X-ray hysterosalpingography (HSG) examination, and the results were compared with the 4D-HyCoSy test results,the sensitivity, specificity,accuracy positive predictive value and negative predictive value of 4D-HyCoSy examination of tubal patency were 95.8%, 93.3%, 96.8%, 97.8% and 93.3%. 4D-HyCoSy had high sensitivity, specificity, accuracy, positive predictive value and negative predictive value, And X-ray lipiodol imaging examination has a very good consistency.Conclusion 4D-HyCoSy can make an objective evaluation of tubal patency, and provide objective and accurate basis for clinical treatment.