〔Abstract〕 Objective To analyze the value of magnetic resonance imaging (MRI) in differentiating pathological subtypes of hysteromyoma. Methods A retrospective analysis of 80 patients with hysteromyoma were treated in the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to February 2020. The accuracy of MRI in identifying pathological subtypes of hysteromyoma was compared with pathological diagnosis as the "gold standard". Results Pathological examination showed 84 leiomyomas in 80 patients, including 67 common non degenerative leiomyomas, 9 cellular leiomyomas, 4 cystic myomas, 3 myxoid myomas and 1 red degenerative myoma. MRI correctly diagnosed 54 ordinary undifferentiated leiomyomas, 7 cellular leiomyomas, 3 cystic leiomyomas, 2 myxoid leiomyomas and 1 red degenerative leiomyoma. A total of 67 cases were classified accurately with the diagnostic accuracy of 79.76%. Conclusion MRI has a high accuracy in identifying pathological subtypes of hysteromyoma, which can help to distinguish whether fibroids are degenerative or not, and provide a reference for clinical conservative treatment.