To estimate diagnostic accuracy of sonography in the diagnosis of adenomyosis in current practice, compared to pathology as a gold standard. Women managed by hysterectomy for benign pathology from January 2015 to November 2018. Preoperative pelvic sonography reports were collected, including details on diagnosis criteria for adenomyosis. Sonographic findings were compared to pathological results of hysterectomy. We included 510 women, 242 had adenomyosis at pathological examination.