Objective:To investigate clinical diagnostic value of transvaginal color Doppler ultrasound on atypical ectopic pregnancy. Methods:Transvaginal color Doppler ultrasound two-dimensional images, blood flow distribution and frequency spectrum characteristics of 32 atypical ectopic pregnancy patients confirmed by operative pathological diagnosis in past 4 years were retrospectively analyzed. Results:Transvaginal color Doppler ultrasound displayed atypical ectopic pregnancy lesions clearly: 20 cases (62.5%) with annex area pouch and solid bag piece, 9 cases (28.1%) with annex area solid bag piece, 3 cases (9.4%) had only oviduct local increase coarse swollen; 4 cases (1.3%) with intrauterine “false pregnancy sac” signs; 25 cases(78.1%) with and 7 cases(21.9%) without endometrial thickening; all cases with abdominal pelvic cavity accumulated fluid pine; nourish blood flow signal was detected in 29 cases(90.6%), pulsed Doppler spectrum showed the high-speed low resistance widened bloods tream spectrum, the resistance index was 0.40±0.07, 3 cases(9.4%) were failed to explore blood flow signal. Color Doppler ultrasound diagnostic accuracy rate was 81.3%(26/32). Conclusion:Transvaginal color Doppler ultrasound display images clearly and fast, don’t need to fill bladder. Early diagnosis of the atypical ectopic pregnancy based on ultrasonographic and blood flow spectrum performance characteristics has high accuracy rate, and should be a preferred choice in clinical examination.