Objective?To study the application value of vaginal four-dimensional contrast-enhanced ultrasonography (4D-HyCoSy) in evaluating tubal patency, pelvic adhesion and tubal function, to provide reference for clinical practice. Methods?A retrospective analysis was conducted on 96 infertile patients admitted to Guangzhou Conghua Maternal and Child Health Hospital from January to August 2020. The patients were divided into no-unobstructed group (62 cases) and unobstructed group (34 cases), With the detection results of laparoscopic Meilantong dye solution as the gold standard, the consistency between 4D-HyCoSy test results and laparoscopy results was analyzed, the value of 4D-HyCoSy test results was analyzed. Results?The consistency analysis showed that the results of 4D-HyCoSy in judging tubal patency were highly consistent with those of laparoscopy (Kappa value =0.820, P ＜0.05), the accuracy of 4D-HyCoSy in judging tubal patency was 91.67%. The consistency analysis showed that the results of 4D-HyCoSy in judging tubal function were highly consistent with those of Canadian fallopian tube function scoring system (Kappa value =0.811, P ＜0.05), the accuracy of 4D-HyCoSy to judge the normal of fallopian tube function was 86.46% respectively. The Kappa consistency analysis showed that 4D-HyCoSy was highly consistent with the pelvic adhesion scoring system of Peking Union Medical College Hospital in judging peripelvic adhesion (Kappa = 0.875, P ＜ 0.05). The accuracy of 4D-HyCoSy to judge the peripelvic adhesion was 93.75%. Conclusion?The 4D-HyCoSy examination has high accuracy in evaluating tubal patency and tubal function, and it is helpful to screen peripelvic adhesions.