Abstract：Objective To evaluate the therapeutic effect of hysteroscopy on the changes of endometrial blood flow in patients with severe intrauterine adhesions (IUAs) by using three-dimensional power Doppler ultrasound (3D PDUS). Methods:40 patients with severe intrauterine adhesions diagnosed by hysteroscopy were collected. Before and after the operation, all the patients were examined by two-dimensional ultrasound and 3D PDUS. To obtain three-dimensional endometrial vascular parameters by using 4D VOCAL software, including the vascular index (VI), flow index (FI) and vascularization flow index (VFI), and endometrial volume were compared before and after surgery to change Results:The 40 patients with severe IUAS, the endometrial volume, VI, FI, VFI were significantly higher after the removal of IUA, and the difference was statistically significant (P = 0.05). After 6 months of follow-up, the menstrual cycle of the patients in the 15 patients was gradually increased, and the blood flow was improved in the 14 patients.