Objective · To evaluate the clinical value of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound in the diagnosis of uterine space-occupying lesion.  Methods · A total of 75 patients with uterine space-occupying lesion were enrolled in this study from March 2015 to February 2016 at Hospital of Southwest Medical University. Patients received both two-dimensional ultrasound and four-dimensional color Doppler ultrasound to determine the location, number and nature of the lesions, as well as the clinical staging of malignant lesions, then the diagnostic accuracy was evaluated.  Results · Among 75 patients, there were 26 cases with endometrial carcinoma, 21 cases with hysteromyoma, 16 cases with metropolypus, and 12 cases with uterine adenomyosis. The diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the uterine space-occupying lesion was 88.0%, which was significantly higher than that of two-dimensional ultrasound (64.0%) (P<0.05). What's more, the diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the clinical staging of endometrial carcinoma was 88.5%, which was significantly higher than that of two-dimensional ultrasound (61.5%) (P<0.05).  Conclusion · Two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound is more effective to improve the diagnostic accuracy of uterine space occupying lesion and clinical staging of endometrial carcinoma in comparison with two-dimensional ultrasound, which will favor the clinical strategy for the treatment of uterine space-occupying lesion.