Objective To compare and analyze the application of ultrasound and magnetic resonance ( M R) examination in evaluating the progress of hemophilia arthropathy( HA ) . Methods Forty‐three cases of HA patients treated in our hospital were collected and divided into observation group and control group according to with or without synovial hyperplasia by ultrasonography at the beginning of the observation period . At the beginning and end of the observation period , ultrasound and M R examinations were performed respectively . T wo imaging findings of the target joint were recorded and scored by ultrasound and M R . T wo types of imaging findings were compared and statistically analyzed . Results T here were positive linear correlations between the ultrasonic score and M R score at the beginning and the end of the observation period ( r ＝ 0 .945 ,0 .943 ; all P ＜ 0 .01 ) . However , there were significant differences in hemosiderin deposition and subarticular bone erosion ( all P ＜0 .05) . A t the end of the observation period , the level of synovial thickening ,the degree of cartilage erosion ,the degree of bone erosion ,the score of ultrasonic joint and M R score were significantly higher than those in the observation period , and the difference were statistically significant compared with the control group ( all P ＜0 .05) . T herefore ,synovial membrane hyperplasia can be considered as the key clinical manifestation leading to rapid progress of hemophilia target joint . Ultrasound measurement of synovial thickness ,ultrasonic score and M R score can be used as a method to predict the progress of the target joint disease . T he areas under the ROC curve were 0 .829 ,0 .897 , 0 .894 , and the cut‐off values were 2 .25 mm , 3 .5 score and 3 .5 score , respectively . Conclusions Ultrasound and MR imaging have a good correlation in evaluating HA .Significant synovial thickening of target joint indicates that HA will continue to progress .