Objective To compare the results of ' one-step ' hysterosalpingo-contrast sonography in patients with primary and secondary female infertility. Methods The clinical and ultrasonic imaging data of 112 infertility patients who underwent ' one-stop ' hysterosalpingo-contrast sonography in the Department of Ultrasound Medicine,Huizhou Central People's Hospital from September 2023 to June 2024 were retrospectively collected. According to the type of disease,they were divided into primary group (44 cases) and secondary group (68 cases). All patients underwent ' one-stop ' hysterosalpingo-contrast sonography. The endometrial thickness,endometrial classification,uterine cavity abnormality rate,ovarian abnormality rate and tubal abnormality rate were compared between the two groups. Results There was no significant difference in endometrial thickness and endometrial classification between the two groups (P>0.05). The abnormal rates of uterine cavity and ovary in the primary group were higher than those in the secondary group,and the differences were statistically significant (P<0.05). However,there was no significant difference in the abnormal rate of fallopian tube between the two groups (P>0.05). Conclusion One-stop hysterosalpingo-contrast sonography can identify patients with primary and secondary infertility,and provide important reference information for the subsequent formulation of individualized and precise treatment plans.