ABSTRACT Objective To evaluate the efficacy of transabdominal combined with transperineal ultrasonography in assessing Crohn''s disease. Methods A total of 87 patients with Crohn''s disease admitted to our hospital were examined by transabdominal ultrasonography combined with transperineal ultrasonography. The thickness of intestinal wall, intestinal wall blood flow grading, intestinal elastic imaging value and parenteral complications were observed. The degree of intestinal wall inflammation was examined by colonoscopy and SES-CD score and histological biopsy were performed. The concentration of hypersensitive C-reactive protein was collected by laboratory examination. The correlation of ultrasonic parameters with colonoscopy results and C-reactive protein was analyzed. Results In this study, a total of 435 intestinal segments were examined using ultrasound and colonoscopy in 87 patients with CD. The colonoscopy results showed that 326 (74.94%) intestinal segments were in the remission stage, while 109 (25.06%) were in the active stage. Among these active segments, 59.8% (52/87) were located in the terminal ileum. Correlation analysis revealed that there was a strong positive correlation between intestinal wall thickness and Limberg blood flow grade with SES-CD stage (r=0.796, 0.742, P < 0.001). The thickness of the ileum wall and Limberg blood flow grade were moderately positively correlated with hypersensitive C-reactive protein (r = 0.496, 0.399, both P < 0.05). However, no correlation was observed between SWE value and SES-CD score. Conclusion Transabdominal combined transperineal intestinal ultrasound provides clear visualization of intestinal lesions and parenteral complications in patients with Crohn''s disease. It offers an accurate evaluation of the level of lesion activity, thus holding significant clinical value.