The study was intended to eliminate the noise in three-dimensional transvaginal ultrasound (3D-TVS) images and improve the diagnostic accuracy in intrauterine adhesion (IUA). The extreme learning machine (ELM) algorithm was introduced first for statement. One hundred and thirty cases of suspected IUA patients were taken as the research subjects. The denoising effects of ELM algorithm were evaluated in terms of mean square errors (MSE), peak signal-to-noise ratio (PSNR), and running time, and its diagnostic efficiency of IUA was identified from precise, specificity, and sensitivity. Furthermore, the support vector machine (SVM) algorithm was introduced for comparison. It was found that the MSE and PSNR of the ELM algorithm were 0.0021 and 64.5, respectively, and its average operation time was 11.22 ± 0.89s, that the MSE values of SVM algorithm and ELM algorithm were 0.0045 and 0.0021 and the PSNR values were 52.3 and 64.5, respectively, and that the average running time of SVM algorithm was 16.35 ± 1.33s, and the average running time of ELM algorithm was 11.22 ± 0.89s, superior to the SVM algorithm in denoising effects. Moreover, the ELM algorithm showed excellent diagnostic efficiency for patients with various degrees of IUA. In conclusion, ELM can effectively eliminate noise in 3D-TVS images and demonstrates excellent diagnostic efficiency on IUA, which is worthy of clinical application.