〔Abstract〕 Objective To investigate the diagnostic coincidence rate of transvaginal color Doppler sonography (TVCDS) in patients with uterine scar pregnancy (CSP). Methods The clinical data of 62 patients with CSP admitted to Xiamen Changguang Hospital from January 2017 to October 2020 were retrospectively collected as the observation group, and another 52 patients with non-CSP admitted to our hospital during the same period were enrolled as the control group. All patients underwent TVCDS and transabdominal color Doppler sonography (TACDS) examination. The results and diagnostic efficacy of the two examination methods were analyzed, and the imaging manifestations of TVCDS examination for different pregnancy types were analyzed. Results The sensitivity and accuracy of TVCDS were higher than those of TACDS, and the rate of missed diagnosis was lower than that of TACDS, the differences were statistically significant (P < 0.05); but there were no statistically significant differences in specificity and misdiagnosis rate between TVCDS and TACDS (P > 0.05), In the observation group, there were 29 cases of simple gestational cyst type, 25 cases of mass type, and 8 cases of mixed type. The coincidence rate of TVCDS for different pregnancy types was higher than that of TACDS (P < 0.05). Conclusion TVCDS can distinguish different types of CSP, and has the characteristics of high sensitivity, high accuracy and low rate of missed diagnosis in the diagnosis of CSP.