ObjectiveTo study the value of transperineal three-dimensional ultrasound imaging in the diagnosis of pelvic organ prolapse (POP). MethodsFifty-two female patients undergoing transperineal three-dimensional ultrasound imaging between December 2011 and May 2013 were chosen for our study. Thirty-two of them with POP were designated into the observation group, and the other 20 patients with common gynecological diseases were regarded as the control group. Both the two groups of patients underwent transperineal three-dimensional ultrasound imaging in their resting state, action state (Valsalva deep inspiration followed by breath holding), and under levator ani muscle shrinking condition. These three kinds of state images clearly showed pelvic floor levator hiatus area and sagittal levator hiatus lengths change in the patients. ResultsPelvic floor was more relaxed in the observation group than that in the control group. The levator hiatus area and sagittal levator hiatus lengths were larger in the observation group than those in the control group, and the differences were significant (P<0.05). ConclusionTransperineal three-dimensional ultrasound imaging can better display pelvic anatomic structure, improve the effectiveness and accuracy of the diagnosis of pelvic organ prolapse, which is worthy of clinical application.