〔Abstract〕 Objective To explore the clinical effect of vaginal three-dimensional ultrasound OmniView imaging in the diagnosis of congenital uterine abnormalities (CUM). Methods A total of 86 CUM patients admitted to Fujian Provincial Maternity and Child Health Hospital from January 2020 to May 2021 were selected as the research objects. All of them underwent three-dimensional and two-dimensional vaginal ultrasound examinations, and used OmniView imaging to examine the cervical canal, uterine shape, and uterus. The morphology of the cavity, with clinical results as the gold standard, to observe the diagnostic effect of the above two ultrasound examinations on uterine classification. Results 86 cases of CUM patients were diagnosed by clinical examination, including 11 cases of double uterus confirmed by laparoscopy combined with hysteroscopy, and 44 cases confirmed by hysteroscopy (1 case of unicornuate uterus, 3 cases of arcuate uterus, 14 cases of complete mediastinal uterus, 26 cases of incomplete mediastinum), 19 cases of tubal lipiodol angiography (7 cases of arcuate uterus, 10 cases of incomplete mediastinum, 2 cases of double uterus), and 12 cases of MRI (7 cases of unicornuate uterus and 5 cases of double uterus) After two-dimensional and threedimensional inspections, the coincidence rate of three-dimensional ultrasound (96.51%) was significantly higher than that of twodimensional ultrasound (87.21%), and the difference was statistically significant (P < 0.05). Conclusion The vaginal threedimensional ultrasound OmniView imaging has a significant effect on the identification of CUM classification.