Objective To explore the value of transvaginal ultrasound in the clinical diagnosis of uterine incision diverticulum after cesarean section. Methods Eighty patients with suspected uterine incision diverticulum after cesarean section in Pingshan People’s Hospital of Shenzhen from June 2016 to December 2019 were selected as study subjects. Abdominal ultrasound diagnosis and transvaginal ultrasound diagnosis were performed respectively.Hysteroscopy was used as the gold standard to compare the diagnostic agreement rate, specificity, and sensitivity of transvaginal ultrasound and abdominal ultrasound. Results The diagnostic sensitivity, specificity, and agreement rate of transvaginal ultrasound were 87.50%, 85.42%, and 86.25%, respectively, higher than those of abdominal ultrasound （62.50%, 62.50%, and 62.50%, respectively）, with statistically significant differences （P<0.05）. Conclusion Transvaginal ultrasound in the diagnosis of uterine incision diverticulum after cesarean section has high sensitivity and specificity, and has positive significance for improving the diagnostic accuracy of uterine diverticulum.