Objective To explore the application value of MRI in the differential diagnosis of uterine sarcoma and denatured uterine fibroids. Methods The clinical data and imaging data of 24 cases of patients with uterine sarcoma and 32 cases of patients with denatured uterine fibroids proved by histopathology in our hospital were retrospectively analyzed. All patients were given dynamic contrast-enhanced MRI examination, and the imaging features were compared between the two groups. The apparent diffusion coefficient (ADC), maximum contrast enhancement rate (MCER) and time-signal intensity curve (TIC) of the lesions were analyzed, and the differences among different uterine sarcomas were observed. Results The preoperative MRI examination showed that the diagnosis rate of patients with uterine sarcoma was 100.0%, and the diagnosis rate of patients with denatured uterine fibroids was 96.42%, therefore the difference was not statistically significant (P>0.05). The values of ADC (0.84±0.08)10-3mm2 /s, TTP (43.85±5.13)s and MCER (241.63±43.65) in the uterine sarcoma group were significantly lower than those of the denatured uterine fibroids group with (1.42±0.15)10-3mm2 /s, TTP (54.26±4.53) s, MCER (143.14±16.83), therefore the difference was statistically significant (P<0.05). There were 21 cases of TIC type I and 2 cases of type II and 1 case of type I in the uterine sarcoma group, and there were 26 cases of TIC type I, 6 cases of type II, and no TIC type III in the denatured uterine fibroids, but the difference was not statistically significant (P>0.05). Conclusion MRI images of uterine sarcoma and denatured uterine fibroids can be presented high signal of T2WI, but the values of ADC, TTP and MCER in patients with uterine sarcoma are significantly lower than those in the patients with denatured uterine fibroids. And MRI can effectively identify uterine sarcoma and denatured uterine fibroids, therefore different MRI sequence values can be combined for the clinical disease diagnosis