To investigate the TCM syndrome characteristics of adenomyosis and provide evidence for syndrome differentiation in clinical practice.Methods:A cross-sectional survey was carried out for 180 patients with adenomyosis who visited the department of gynecology in the Dongfang Hospital，Beijing University of Chinese Medicine from May 2020 to December 2021，and the information of four examinations was collected.The patients were grouped according to uterine volume，presence of uterine fibroids or not，and uterine cavity manipulation or not，and the TCM syndrome characteristics of the patients in different groups were summarized.Results:In this study，the age of onset was 40 to 50 years old，and the most common symptom of adenomyosis was dysmenorrhea，and the syndrome elements associated with the disease location and nature mainly included uterus，liver，heart，kidney，qi stagnation，blood stasis，yang deficiency，and yin deficiency.The cluster analysis showed that the common combinations of syndrome elements were yin deficiency with effulgent fire，qi stagnation with blood stasis，kidney yang deficiency，and phlegm-dampness accumulation.The frequency of dysmenorrhea，presence of masses in menstrual blood，lower abdominal pain，menorrhagia，uterus，qi stagnation，and blood stasis in the group with significantly increased uterine volume was different from that in the group with slightly increased uterine volume(all P<0.05).The frequency of presence of masses in menstrual blood，menorrhagia，dark menstrual blood，heart，and yang hyperactivity in the group with uterine fibroids was different from that in the group without uterine fibroids(P<0.05).The group with uterine fibroids showed differences from the group without uterine fibroids regarding the frequency of lower abdominal pain，cold feeling in the stomach，abdomen，and waist，cold，and dampness(P<0.05).The frequency of dysmenorrhea，presence of masses in menstrual blood，low back pain，lumbar spinal pain，uterus，kidney，and blood stasis showed significant differences between the groups with and without uterine cavity manipulation(P<0.05).Conclusion:The patients with adenomyosis mainly present the synromes of qi stagnation and blood stasis，yin deficiency with effulgent fire，kidney yang deficiency，and phlegm and dampness accumulation.The syndromes of combined phlegm and stasis，qi stagnation and blood stasis，and kidney yang deficiency are more common in the patients without uterine fibroids，with uterine fibroids，and with uterine cavity manipulation，respectively.