Objective To explore the long-term effects of different hysteroscopic surgeries in the treatment of endometrial polyps combined with abnormal uterine bleeding, analyze the effect of hysteroscopic cold knife resection on uterine arterial blood flow parameters and hemoglobin in patients, and provide new ideas for improving clinical efficacy. Methods According to the random number table method, 80 patients with endometrial polyps and abnormal uterine bleeding admitted from January 2020 to June 2023 were divided into a reference group and a study group （40 cases in each group）, and hysteroscopic electroresection and hysteroscopic cold knife resection were performed respectively. Endometrial thickness, uterine arterial blood flow parameters, and hemoglobin levels before and after surgery were compared between the two groups. The patients were followed up for 6 months after surgery, and the incidence rates of postoperative complications, recurrence of uterine polyps, and abnormal uterine bleeding in the two groups were recorded. Results At 1, 3, and 6 months after surgery, the patients in the study group had less endometrial thickness than the reference group （P<0.05）. At 6 months after surgery, the blood flow resistance index （RI） and pulsatility index （PI） of the study group were lower than those of the reference group, and the hemoglobin level was higher （P<0.05）. The postoperative complication rate in the study group was 5.00%, which was lower than 22.50% in the reference group, and the difference was statistically significant （P<0.05）. The recurrence rate of postoperative endometrial polyps and the incidence rate of abnormal uterine bleeding were lower in the study group than in the reference group （P<0.05）. Conclusion Hysteroscopic cold knife resection of endometrial polyps can effectively reduce endometrial hyperplasia, improve uterine blood circulation, restore hemoglobin level, and have fewer postoperative complications, so the long-term effect on preventing recurrence of endometrial polyps and abnormal uterine bleeding is ideal.