Objective To compare the clinical significance of transvaginal ultrasound and magnetic resonance imaging (MRI) in the diagnosis and treatment of endometrial carcinoma. Methods Fifty-eight patients with endometrial carcinoma confirmed by pathology between January 2015 and July 2016 were examined by transvaginal ultrasound and MRI examination before operation. With postoperative pathological results as the standard, the accuracy was compared between transvaginal ultrasound and MRI in the diagnosis of preoperative staging. The findings of different imaging examinations were observed. Results As for postoperative pathological stage, there were 40 cases in stage Ia, 12 cases in stage Ib, 4 cases in stage II and 2 cases in stage IVa. With postoperative pathological staging as the golden standard, the total accuracy rate of transvaginal ultrasound in the diagnosis of preoperative clinical staging was 86.21%, and of MRI was 87.93% (P>0.05). Conclusion The accuracy rate of both transvaginal ultrasound and MRI in the diagnosis of preoperative staging of endometrial carcinoma are high, which can provide important basis for development of preoperative operation of endometrial carcinoma.