Objective: To explore the application value of hydrotubation under transvaginal ultrasound monitoring for tubal patency examination of infertile women in infertility clinic. Methods: A total of 200 patients with tubal examination requirements and indications for tubal examination in infertility outpatients were selected as the research objects. DC-N3S (equipped with vaginal probe) color Doppler ultrasound system (Mindray) was used for real-time monitoring before, during and after operation. Liquid preparation: gentamicin 80 000 units, chymotrypsin 4000 U, dexamethasone 5 mg, normal saline 60 mL. By observing the flow of fluid in the uterus and fallopian tubes, the patency of fallopian tubes was judged by the distribution of fluid in the pelvic cavity and vaginal reflux. Results: A total of 121 patients were fallopian tube patency; 79 patients were abnormal fallopian tube patency (21 patients were bilateral obstruction, 26 patients were unilateral obstruction, and 32 patients were bilateral or unilateral fallopian tube obstruction). Among them, 12 patients were diagnosed by hysterosalpingography (HSG) in other hospitals, and the diagnosis results were consistent with the results of hydrotubation. Conclusion: Hydrotubation under transvaginal ultrasound monitoring has the advantages of high accuracy, safety, low cost and high patient acceptance.