Objective: To investigate the role of pelvic floor ultrasound in the evaluation of the rehabilitation efficacy of postpartum stress urinary incontinence (SUI). Methods: A total of 106 postpartum women with SUI (all delivered in our hospital between June 2022 and June 2024) were enrolled in the study. All patients underwent pelvic floor muscle training and were divided into a significant efficacy group (n=90) and a poor efficacy group (n=16) based on the training. Results: Both groups underwent pelvic floor ultrasound examination. The pelvic floor ultrasound examination parameters under Valsalva maneuver were compared between the two groups, and the cystocele rate and urethral funnel formation rate were recorded. Results After rehabilitation, the bladder neck movement under Valsalva maneuver 24.15±4.82mm and the posterior urethral angle (130.63±9.51)° in the significant efficacy group were significantly lower than those in the poor efficacy group, and the levator ani strain rate (20.15±3.20)% was significantly higher than that in the poor efficacy group (P<0.05). The rates of cystocele (15.56% vs 43.75%) and urethral funneling (12.22% vs 37.50%) in the significant efficacy group were significantly lower than those in the poor efficacy group (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the AUCs for bladder neck mobility, posterior urethral angle, levator ani strain rate, and their combined effect in predicting the rehabilitation efficacy of postpartum SUI patients were 0.790, 0.802, 0.725, and 0.851, respectively. When the critical values of the three indicators were 25.893 mm, 124.120°, and 18.774%, respectively, the corresponding sensitivities were 90.00%, 93.33%, and 87.78%, respectively. The combined sensitivity of the three indicators was 95.56%. Conclusion: Pelvic floor ultrasound has a certain value in evaluating the rehabilitation efficacy of postpartum SUI and can provide an objective basis for patient prognosis.