Objective: To analyze the imaging characteristics and diagnostic value of endometrial polyps under transvaginal two-dimensional ultrasound. Methods: 103 patients with suspected endometrial polyps admitted to our hospital from March 2023 to August 2024 were selected as the research subjects. All patients underwent two-dimensional ultrasound examinations via the abdomen and vagina respectively, and received pathological examinations of endometrial lesions at an appropriate time. Take the pathological diagnosis of endometrial lesions as the gold standard for diagnosis. Analyze the examination results of transabdominal and transvaginal ultrasound. To comparatively analyze the diagnostic value of transabdominal and transvaginal ultrasound for endometrial polyps. Results: Among the 103 patients diagnosed by endometrial lesion pathology, 41 cases of endometrial polyps were confirmed, accounting for 39.81%. Taking the pathological diagnosis results of endometrial lesions as the gold standard, 27 cases and 35 cases of endometrial polyps were detected by transabdominal and transvaginal ultrasound examinations respectively, and the detection rates were 65.85% and 85.37% respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of transvaginal ultrasound are all higher than those of transabdominal ultrasound, and the consistency with the gold standard is also higher. Conclusion: Transvaginal two-dimensional ultrasound has a high diagnostic value for endometrial polyps.