Objective: To investigate the clinical value of ultrasonic measurement of monolayer endometrium thickness in asymptomatic menopausal effusion. Methods: A total of 100 menopausal women with asymptomatic effusions and asymptomatic menopausal women admitted to the Second Affiliated Hospital of Hainan Medical College from January 2018 to December 2019 were analyzed, the relationship between the thickness of single layer endometrium, the amount of intrauterine effusion and endometrial lesions was summarized. Results: Among the 200 patients, 72 were atrophic endometritis, 65 were inadequate endometrium, and 63 were endometrial pathological changes (including 41 endometrial polyps, 20 endometrial hyperplasia, and intrauterine Membrane dysplasia in 2 cases), no cases of endometrial cancer. The probability of endometrial lesions in menopausal asymptomatic patients with endometrial thickness ≤3 mm was significantly lower than that in patients with endometrial thickness >3 mm, the difference between endometrial lesions and monolayer endometrial thickness had statistical significance (P<0.05), there was no significant difference in the amount of endometrial lesions and intrauterine effusion (P>0.05). Conclusion: The thickness of the single-layer endometrium is closely related to the endometrial lesions. The thicker the single-layer endometrium, the higher the probability of endometrial malignant lesions. The thickness of the single-layer endometrium in patients with asymptomatic uterine effusion during menopause follow-up, patients with asymptomatic uterine effusion in menopausal patients with a single-layer endometrial thickness >3 mm should undergo ultrasound examination in time, and if necessary, combined with hysteroscopy to avoid uterine lesions and uterine cancer.