To analyze the related factors affecting the accuracy of transvaginal ultrasonography for diagnosing the early ectopic pregnancy. Methods: A retrospective analysis was conducted on the clinical data of 213 patients with early suspected ectopic pregnancy screening by transvaginal ultrasound from January 2020 to December 2022. The accuracy rate of the transvaginal ultrasonography diagnosis of ectopic pregnancy was evaluated by the subsequent surgical and pathological results. Logistic regression model was used to analyze the related factors affecting the accuracy of transvaginal ultrasonography of the patients for diagnosing their early ectopic pregnancy. Results: In 213 patients with the suspected early ectopic pregnancy, there were 167 cases with the confirmed ectopic pregnancy, and the accuracy rate of the transvaginal ultrasound of the patients for diagnosing their early ectopic pregnancy was 78.4%. Among them, there were 12(5.6%) patients with heterogeneous mass type(gestational sac rupture), 98(46.0%) patients with fallopian tube ring type, 33(15.5%) patients with gestational sac type, and 24(11.3%) patients with embryonic sac type. Single factor analysis showed that there was significant difference in the diagnostic accuracy by ultrasound among the patients with different value of body mass indices(BMI), among the patients with different pelvic fluid accumulation situation, and among the patients with different serum human chorionic gonadotropin(β-hCG) level(P<0.05). Multivariate logistic regression model analysis showed that the BMI ≥ 28.0 kg/m2, the pelvic fluid accumulation, the serum β- HCG level and the unknown site pregnancy of the patients were the independent influencing factors affecting the accuracy of transvaginal ultrasound diagnosis of the ectopic pregnancy(all P<0.05). Conclusion: When the patients with suspected ectopic pregnancy are diagnosed by ultrasound, the obese patients, the patients with pelvic effusion, and the patients with pregnancy at unknown sit should be combined with the serum β-hCG level for diagnosis, so as to improve the accuracy of the ultrasound diagnosis of ectopic pregnancy.