To investigate the clinical efficacy of levonorgestrel intrauterine sustained release system (LNG-IUS) combined with drospirosterone ethinylestradiol tablets for treating women with endometrial hyperplasia (EH) and without atypical hyperplasia. Methods: From April 2018 to October 2020, 64 women with EH and without atypical hyperplasia were selected and were divided into two groups (32 cases in each group) according to the principle of random numbers. The women in group A were given LNG-IUS and the women in group B were given LNG-IUS combined with drospirosterone ethinylestradiol tablets. The menstrual volume, hemoglobin level, endometrial thickness, endometrial blood vessel index (VI), blood flow index (FI), and vessel flow index (VFI) before and after treatment, and the incidence of adverse reactions of the women were compared between the two groups.  Results: After treatment, the duration of menstrual period and the endometrial thickness of the women in group B were significantly less than those of the women in group A, but the Hb level of the women in group B was significantly higher (all P<0.05). After treatment, the values of VI, FI, and VFI of endometrial blood flow of the women in the two groups had decreased significantly, but which of the women had no significant different between the two groups (P>0.05). The incidences of vaginal irregular bleeding (40.6%) and acne (18.8%) of the women in group A were significantly higher than those (15.6% and 3.1%) of the women in group B (P<0.05), but there were no significant differences in the incidence of LNG-IUS moved down, weight gain, and ovarian cyst occurrence of the women between the two groups (P>0.05). Conclusion: LNG-IUS combined with drospirosterone ethinylestradiol tablets for treating women with EH has higher effectiveness with less adverse reactions.