Abstract: Objective To explore the value of transvaginal color Doppler ultrasonography in differential diagnosis of threatened abortion in pregnant women in early pregnancy. Methods The clinical data of 60 pregnant women with threatened abortion in early pregnancy from October 2016 to August 2019 were retrospectively analyzed, and they were selected as research group. During the same period, 60 pregnant women in early pregnancy with normal checkups were selected as control group. Pregnant women in both groups were treated with transvaginal color Doppler ultrasonography. The pulsation index and resistance index of uterine artery, spiral uterine artery and luteal blood flow were compared between the two groups, and the ultrasonic imaging features of the two groups were compared. Results There were no significant differences in the pulsation index and resistance index of uterine artery between two groups(P>0.05), but the pulsation index and resistance index of uterine spiral artery and luteal blood flow in the research group were significantly higher than those in the control group(P<0.05). In the control group, the shape of the gestational sac was plump, the size of the embryo bud was consistent with the gestational age, the yolk sac could be seen, and the fetal heart beat was normal. In the research group, the position of the gestational sac was normal, or it was in the middle and lower part of the uterine cavity, the shape of the gestational sac was mild irregular or normal, the embryo bud was slightly small or normal, and the yolk sac, fetal heart and primitive heart tube were normal. Conclusion Transvaginal color Doppler ultrasound has a significant value in the differential diagnosis of threatened abortion in pregnant women in early pregnancy.