Objective To explore the diagnostic value and advantage of magnetic resonance and ultrasonography in the diagnosis of female pelvic cystic lesions. Methods The ultrasound and magnetic resonance imaging data of 59 cases of female pelvic cystic lesions were analyzed retrospectively, which included 6 cases of benign ovarian cystadenoma, 2 cases of cystadenocarcinoma, 31 cases of ovarian cysts (12 cases of simple cysts, 19 cases of endometrial cysts), 4 cases of cystic teratoma, 6 cases of tubal effusion, 4 cases of tubal pregnancy and 6 cases of pelvic abscess. Results The diagnostic accuracy was 93.22 % (55/59) of ultrasound, and the accuracy was 96.61 % (57/59) of MRI, the accuracy of the two methods was not statistically significant. The signal characteristics of MR sequence can accurately reflect the internal components and adjacent results, and can provide more accurate localization diagnosis for the operation. Conclusion The examination of ultrasound is cheap and convenient, and is the first choice examination method of the diagnostic of female pelvic cystic lesions. Magnetic resonance can clearly display the lesion itself and its relationship with peripheral, and it can correctly reflect the internal components of the lesion, which can improve the qualitative and localization diagnosis of female pelvic cystic lesions before operation.