Abstract：Objective To compare the clinical effect of transvaginal endoscopy and conventional colposcopy in the diagnosis of cervical lesions. Methods A total of 120 patients who underwent cervical cancer screening and were found to have suspicious cervical abnormalities requiring further evaluation at the Second Affiliated Hospital of Southern Anhui Medical College between March 2023 and April 2024 were enrolled. Patients were divided into a control group and an experimental group based on the diagnostic method used, with 60 patients in each group. The control group underwent conventional colposcopic examination, while the experimental group underwent transvaginal endoscopic examination. Operation time, complication rate, procedure failure rate, pathological concordance rate, and patient satisfaction were compared between the two groups.  Results The complication rate and procedure failure rate in the experimental group were significantly lower than those in the control group （both P＜0.05）. Patient satisfaction was significantly higher in the experimental group compared to the control group （t＝2.23, P＜0.05）. There was no statistically significant difference in operation time between the two groups （t＝1.83, P＞0.05）, nor in pathological concordance rate （P＞0.05）. Conclusion Transvaginal endoscopy offers a minimally invasive, safe, and accurate approach for diagnosing cervical lesions. It improves diagnostic accuracy while reducing patient stress, discomfort, and complication risk during the procedure.