Objective: In this study, we analyzed the ultrasonic image characteristics of juvenile granulosa cell tumor (JGCT) of the ovary, and discussed the correlation between the ultrasonic characteristics and pathological findings, so as to enhance the understanding of JGCT by sonographers.Methods: 4 patients who received surgical treatment in Shanxi Children's Hospital from June 2013 to June 2023 were retrospectively collected and pathologically proved to be JGCT patients. Ultrasound images and pathological features of the lesions were analyzed.Results: The patients were girls aged 6-17 years old, and the lesions were all larger than 6cm in diameter, with cystic firmness, clear boundaries, regular shape, multiple compartments in the cystic part, no blood flow signal, poor internal sound transmission, and uneven high echo in the solid part compared with muscle layer, rich blood flow signal, and low-resistance arterial spectrum, RI≤0.5. There were 4/4 cases with abdominal effusion, 3/4 cases with endometrial thickening, 2/4 cases with pleural effusion and 1/4 cases with pericardial effusion. All effusions were sound-clear. Pathologically, JGCT is formed by diffuse proliferation of granulosa cells, accompanied by neovasculature, cystic components filled by fluid secreted by granulosa cells, or bleeding.Conclusion: The JGCT ultrasound images are mostly large solid sac with multiple serous effusion, and there is a close correlation between the ultrasonic findings and histopathology.