Objective To discuss the MRI features of pyometra and its correlation with pathologic.Methods MRI and DWI data of 12 cases pyometra proved by surgery and pathology were analyzed retrospectively, and a comparision with pathologic findings was made.Mean ADC values were calculated.Results According to the homogeneity of MRI signal: Uniform signal type in 2 cases,T1WI showed slightly low signal,T2WI showed slightly high signal,DWI showed high signal,and the distribution of pus compositions is relatively uniform;Signal mixed type in 5 cases, T2 showed at the bottom of the pus or peripheral mixed slightly short signal, DWI showed mixed high signal, there was some sediment in the bottom of the pus;5 cases of liquid layer type, the upper displayed signal of water,and the lower signal was lower than the upper signal on T2WI, of which 3 cases showed uniform signal of the lower, DWI showed a uniform high signal, the distribution of pus compositions is uniform, the other 2 cases showed mixed signal of the lower, which was pyometra with bleeding,DWI showed high signal and low signal mixed together.The average ADC value of the 12 patients were 0.532×10-3 mm2/s.12 cases of uterine volume were increased, including 10 cases of uterine wall thinning, the other 2 cases with inflammatory invasion, the uterine wall thickening.8 cases with cervical cancer.5 cases with pelvic effusion.Conclusion MRI findings of pyometra are characteristic, its MRI manifestations and pathological components are highly correlated,and the ADC value is of great value in the diagnosis of pyometra.