Objective To investigate pelvic ultrasound imaging features of stress incontinence in women, and to lay a scientific foundation for clinical improvement of the efficacy of patients with stress urinary incontinence. Methods A total of 98 stress urinary incontinence patients in our hospital and in hospital from March 2015 to March 2017 were selected as the study group. The same period in our hospital in the health examination of 98 women were selected as a control group. Two-dimensional and three-dimensional images of the patient at rest and in the Valsalva state were collected, and the images were collected using Doppler ultrasound original software for analysis. Results The inclination of urethra and the posterior angle of bladder urethra in the study group were lower than those in the control group (P < 0.05), and the area of levator ani muscle cleft in the study group was larger than that in the control group (P < 0.05). The bladder position and bladder neck position in the study group were lower than those in the control group (P < 0.05), and the urethra inclination, posterior angle of bladder urethra and the area of levator ani muscle cleft in the study group were higher than those in the control group (P < 0.05). The mobility of bladder neck and the rotation angle of urethra in the study group were higher than those in the control group (P < 0.05). The formation rate of urethral funnel in the study group was higher than that in the control group (P < 0.05). Conclusions Pelvic floor ultrasound imaging can effectively identify changes in pelvic floor morphology of stress urinary incontinence. The occurrence of stress incontinence is closely related to the defects of supporting structures such as urethra, bladder neck and levator ani muscle.