Objective: To investigate the diagnostic efficacy of 3D-TVS OmniView imaging technology combined with tomographic imaging in patients with intrauterine adhesions (IUA). Methods: A total of 150 suspected IUA patients admitted to our hospital and confirmed by hysteroscopy were selected as the study sample from January 2024 to December 2025. All patients underwent preoperative 3D-TVS OmniView imaging scans, and the tomographic imaging mode was employed to observe linear interruptions of the endometrium, alterations in uterine cavity morphology, and adhesion bands. The results of hysteroscopy were used as the “gold standard” for this study, and the diagnostic efficacy of 3D-TVS alone versus 3D-TVS OmniView imaging combined with tomographic imaging in diagnosing IUA was compared. Results: Among the 150 patients, hysteroscopy diagnosed a total of 112 cases (74.7%) of IUA. The sensitivity, specificity, and accuracy of 3D-TVS alone in diagnosing IUA were 82.1%, 78.4%, and 81.0%, respectively; whereas the sensitivity of 3D-TVS OmniView imaging combined with tomographic imaging significantly increased to 93.7%, with a specificity of 89.2% and an accuracy of 92.0%, all of which were significantly higher than those of 3D-TVS alone (P < 0.05). In terms of adhesion degree identification, combined imaging demonstrated higher consistency in judging moderate and severe adhesions (κ = 0.82), particularly in displaying deformations of the uterine cavity contour, adhesion bridges, and focal atresia with greater clarity. Conclusion: The implementation of 3D-TVS OmniView combined with tomographic imaging in patients with intrauterine adhesions yields higher diagnostic accuracy. This non-invasive, intuitive imaging method holds significant clinical value and can serve as an important screening tool prior to hysteroscopy, meriting widespread adoption and application.