ObjectiveTo evaluate the value of ultrasound in the differential diagnosis of thickened bowel wall at the lower quadrant of abdomen. MethodsThe ultrasonic and clinical data of 416 cases of bowel wall thickening at the lower quadrant of abdomen were retrospectively analyzed between January 2009 and April 2013 in Meishan Traditional Chinese Medicine Hospital, Meishan Chinese Railway Hospital and West China Hospital of Sichuan University. The diseases included appendicitis, periappendiceal abscess, Meckel's diverticulum, intestinal duplication, Crohn's disease and intestinal tuberculosis. Misdiagnoses were also analyzed. ResultsAmong the 416 patients, there were 304 cases of inflammation, 90 of tumors, and 22 of congenital diseases. On ultrasound images, they manifested as cystic mass in 19 cases, mixed solid and cystic mass in 77 cases, and solid mass in 320 cases. Of all the cases, there were 56 cases of diffused changes, 54 of multiple-segment changes, and 306 of focal changes. ConclusionUltrasound is a valuable diagnostic imaging tool in the differential diagnosis of bowel thickening diseases at the lower quadrant of abdomen.