Objective To investigate the expression of transforming growth factor-β1 (TGF-β1)and matrix metalloproteinase-2 (MMP-2) in the ectopic endometrium of adenomyoma and their relation with the pathogenesis of adenomyoma. Method Endometrial specimens were obtained from 30 normal uteri and 30 with adenomyoma. TGF-β1 and MMP-2 was detected by immunohistochemical SABC staining. Results The expression intensity of TGF-β1 in the ectopic endometrium of adenomyoma and normal endometrium were (65.79±0.13) and (63.22±0.65). The difference had statistical significance(P<0.05).The expressive intensity of MMP-2 in the ectopic endometrium of adenomyoma and normal endometrium were (53.98±0.64) and (52.76±0.86). The difference had statistical significance(P<0.05). Conclusion Overexpression of TGF-β1 and MMP-2 in ectopic endometria of adenomyoma may cause increasing local angiogenesis and enhance the growth and survival of ectopic endometrial implants.