Adenomyosis is a benign uterine disorder where endometrial glands and stroma are pathologically demonstrated within the uterine myometrium. The pathogenesis involves sex steroid hormone abnormalities, inflammation, fibrosis and neuroangiogenesis, even though the proposed mechanisms are not fully understood, the different type and extension of adenomyosis detected by transvaginal ultrasound could be associated with clinical symptoms.  The current study was designed with an aim to correlate between ultrasound finding in symptomatic patient with adenomyosis and severity of the disease. It was a cross sectional study conducted on 100 symptomatic women with sonographic criteria of adenomyosis recruited from the outpatient gynecology and obstetrics clinic after proper counseling, history taking and ultrasound examination to detect ultrasound criteria of adenomyosis and doppler on uterine artery done to all patients to detect uterine artery resistance index, pulsatillity index and V_max. There is a relation between Tumor vascular pattern and abnormal uterine bleeding mainly and chronic pelvic pain. We found non-statistically significant differences between sonographic findings and symptoms among the studied population