To evaluate the effect of different surgical methods of total hysterectomy of women on their pelvic floor dysfunction by transperineal ultrasound examination. Methods: The clinical data of 180 women who underwent total hysterectomy from February 2016 to October 2019 were collected retrospectively. According to the different surgical paths, these women were divided into three groups, which included women with transabdominal hysterectomy group in group A, women with transvaginal hysterectomy in group B, and women with laparoscopic hysterectomy in group C. According to the different scope of operation, these women were also divided into group D (women with intrafascial hysterectomy) and group E (women with extrafascial hysterectomy). Gynecological examination, pelvic organ prolapse quantitative (POP-Q) grading, stress urinary incontinence (SUI) assessment, and transperineal ultrasonographic pelvic floor muscle examination were performed for the women in the three groups 6 and 12 months after surgery. Results: There was no significant differences in the incidences of SUI and POP of the women in 6 months and 12 months after surgery among group A, group B, and group C (P>0.05). The values of ΔA, ΔC, ΔL, andεmeasured by pelvic ultrasound of the women in group A, group B, and group C had increase gradually (P<0.05), but which had no significant differences among group A, group B, and group C (P>0.05). The incidences of postoperative SUI and POP of the women 6 months after operation had no significant differences between group D and group E (P>0.05), but the incidence of SUI in 12 months after operation of the women in group E was significant higher than that of the women in group D (P<0.05), and the incidence of POP of the women in 12 months after operation had no significant difference between group D and group E (P>0.05). The values of ΔA, ΔC, ΔL, andεmeasured by pelvic ultrasound of the women in group D and group E had increased gradually in 6 and 12 months after operation (P<0.05). The values of ΔA, ΔC, andΔL measured by pelvic ultrasound of the women in group D and group E in 6 months after operation had significant differences (P<0.05), but the εvalue had no significant difference between group D and group E (P>0.05). The values of ΔA, ΔC, andΔL measured by pelvic ultrasound of the women in group D in 12 months after operation were significant higher than those of the women in group E (P<0.05). Conclusion: There is no difference in the influence of transabdominal, transvaginal, or laparoscopic total hysterectomy of the women on their pelvic floor muscle function. Intrafascial total hysterectomy of the women may be more beneficial to protecting their pelvic floor muscle function.