ABSTRACT Objective: To compare the clinical efficacy and safety of high intensity focused ultrasound (HIFU) combined with percutaneous ethanol injection (PEI) and single high intensity focused ultrasound (HIFU) in the treatment of adenomyosis. Methods ：From April 2013 to August 2016 , 78 patients with adenomyosis enrolled, of which 31 cases accepted simple HIFU treatment, the other 47 cases were treated with PEI and then HIFU treatment. To evaluate the treatment outcomes and adverse effects between the two groups. Results ：The safety of the two groups was the same, HIFU combined with PEI group was more effective than HIFU group, the treatment time was shortened and the ablation rate was higher.Conclusion：HIFU combined with PEI and simple HIFU treatment of adenomyosis has the same safety, but HIFU combined with PEI group of clinical results better, worthy of promotion.However, the study of the mechanism of ablation of HIFU and PEI may not only be a simple superposition of the two, but also may be related to the change of sound field distribution after PEI and the change of membrane resistance to sound pressure and temperature, which needs further study.