Objective To evaluate the effect of pelvic floor function on total hysterectomy patients by transperineal three-dimensional ultrasonography. Methods Used by the transperineal three-dimensional ultrasonography to dynamic observe the changes of the pelvic floor’s structure in total hysterectomy patients in preoperative 1 day, after 1 month, 3 months, 6 months . Each time measurement of bladder neck to the edge of pubic symphysis vertical distance (R - BSD/V - BSD) and bladder urethra after Angle (R - UJV/V - UJV)in resting and maximum Valsalva condition respectively, calculate the bladder neck movement (BND), urethra rotation Angle (UR), record the biggest anal levator hiatal area in maximum Valsalva condition,then analyze the various parameters of different periods respectively. Results There was no significant difference between the parameters of preoperative 1 day and 1 month after surgery (p>0.05).The differences between R - BSD and R - UJV were not statistically significant in preoperative 1 day and 3 or 6 months after surgery (p>0.05), while the differences between V - BSD, V - UJV, BND, UR and the biggest anal levator hiatal area were statistically significant (p<0.05).Compared with 1 months and 3 or 6 months after the operation, there were no statistically significant differences between R - BSD and R - UJV (p>0.05), while there were statistically significant differences between V - BSD, V - UJV, BND, UR and the biggest anal levator hiatal area (p<0.05).Compared with 3 and 6 months after surgery, there were no statistically significant differences among all parameters (p>0.05). Conclusion The pelvic floor function of the patients after total hysterectomy was not significantly damaged within 1 month, but began to be damaged after 3 months, and then progressed slowly.Transperineal three-dimensional ultrasonography can accurately assess the pelvic floor function of patients after total hysterectomy, and it is recommended that patients undergoing total hysterectomy should be begin pelvic floor rehabilitation training between 1 and 3 months after the operation.