To explore the value of magnetic resonance diffusion-weighted imaging (DWI) combined with vaginal color Doppler ultrasound (TVCDS) for evaluating the lymph node metastasis of patients with endometrial cancer (EC). Methods: The clinical data of 105 patients with EC (in study group) who had been diagnosis and treatment in hospital from January 2018 to August 2023 were selected in this study, and these patients were divided into group A (54 cases with lymph node metastasis) and group B (51 cases without lymph node metastasis) based on whether their lymph node metastasis occurred or not. In addition, 105 patients who came to hospital for examination due to benign endometrial lesions were selected in control group. The quantitative parameters of DWI and TVCDS of the patients were compared among these groups. Logistic regression was applied to analyze the influencing factors of the lymph node metastasis of the patients with EC. ROC curve was applied to analyze the diagnostic value of the parameters of DWI and TVCDS of the patients with EC for their lymph node metastasis. Results: The values of ADC-stand (1.12±0.28×10-3mm2/s), the ADC-slow (0.64±0.16 ×10-3mm2/s), the ADC-fast (72.51±8.59 ×10-3mm2/s), the PI (0.52±0.12) and the RI (0.36±0.08) of the patients in the study group were significantly lower than those (1.63±0.34×10-3mm2/s, 1.02±0.25×10-3mm2/s, 83.62±8.73×103mm2/s, 0.84±0.22 and 0.59±0.14) of the patients in the control group, and which of the patients in group A were significantly lower than those of the patients in group B. The increase of the values of ADC-stand, ADC-slow, ADC-fast, PI and RI of the patients with EC were the independent protective factors for their lymph node metastasis (all P<0.05). The area under the curve (AUC) of the values of ADC-stand, ADC-slow, ADC-fast, PI and RI of the patients with EC for evaluating their lymph node metastasis were 0.735, 0.846, 0.836, 0.852 and 0.831, respectively. The AUC of the combined values of ADC-stand, ADC-slow, ADC-fast, PI and RI of the patients with EC for diagnosing their lymph node metastasis s of each index was 0.931, which was significantly superior to that of the ADC-stand value, the ADC-slow value, the ADC-fast value, the PI value or the RI value alone (P<0.05). Conclusion: The quantitative parameters of DWI and TVCDS of the patients with EC and lymph node metastasis decrease obviously, and the combination of the parameters of DWI and TVCDS values of the patients with EC for evaluating their lymph node metastasis has higher clinical value.