To explore the curative effect of total hysterectomy combined with or without bilateral adnexectomy for treating patients with uterine sarcoma, and to analyze the prognosis of the patients. Methods: 88 patients with uterine sarcoma who had received total hysterectomy from July 2016 to January 2020 were collected retrospectively. 37 patients who had received total hysterectomy only in group A, and 51 patients who had received total hysterectomy and bilateral adnexectomy were in group B. The effect of the patients in the two groups was analyzed and the prognoses of these patients were analyzed during 1 year of followed up after treatment. Results: The operation time of the patients in group B was significantly longer than that of the patients in group A. The values of postoperative ovarian artery resistance index (RI), the minimum blood flow velocity at the end of diastole, and the peak blood flow velocity of systole of the patients in group B were significantly lower than that of the patients in group A, and the pulse index of the patients in group B was significantly higher (all P＜0.05). The incidence of perimenopausal symptoms of the patients in group A (11.8%) was significantly lower than that (32.4%) of the patients in group B. The survival rates in postoperative 3 months (88.2%), in postoperative 6 months (68.6%), and in postoperative 12 months (46.3%) of the patients in group B were significantly higher than those (70.3%, 46.0%, and 27.0%) of the patients in group A (P＜0.05). Conclusion: The curative effect of bilateral adnexectomy during total hysterectomy for treating the patients with uterine sarcomaid is superior to that of total hysterectomy only, which can improve the ovarian artery blood flow status and relieve the perimenopausal symptoms more effectively, and can obviously reduce the recurrence of uterine sarcomaid, and improve quality of life. However, it has greater influence on the ovarian arterial blood flow of the patients. Therefore, appropriate surgical method should be selected based on the condition of the patients in clinical treatment.