Objectives Three-dimensional energy Doppler ultrasonography was used to detect of endometrial carcinoma by comparing the early diagnosis and endometrial cancer group, benign disease group, normal control group and menopausal group. Methods Three-dimensional energy Doppler ultrasonography was used to observe the endometrium of 199 patients with vaginal bleeding (divided into benign lesion group, endometrial carcinoma group and normal group) and 30 cases of menopausal group by collecting and comparing hemodynamic parameters. The hemodynamics parameters including: systolic peak velocity (Vmax), resistance index (RI), pulsatility index (PI), angiogenesis index (VI), blood flow index (FI), angiogenesis-blood flow index (VFI) ,to evaluate the significance of parameters in the diagnosis of endometrial cancer. Results There was no significant difference in the systolic peak flow velocity between endometrial carcinoma group, benign lesion group and normal control group (P> 0.05); There were significant differences in the mean values of RI and PI between endometrial carcinoma group and benign lesion group and normal control group (P <0.01);The vascular parameters VI, FI and VFI of endometrial carcinoma group were higher than those of benign lesion group, normal control group and normal menopause group (P <0.01);The parameters of vascular parameters VI, FI and VFI in benign lesion group were significantly higher than those in normal control group and normal menopause group (P <0.05);The blood flow parameters VI, FI and VFI of the normal control group were higher than those of the normal menopause group (P <0.05).Conclusion Three-dimensional energy Doppler ultrasound can provide valuable information for the differential diagnosis of endometrial carcinoma and benign lesions and normal groups, which can further improve the diagnostic accuracy of endometrial carcinoma and early diagnosis of endometrial cancer significance.