Objective: The aims of this study were to establish a mathematical model to predict intrauterine adhesion (IUA) prognosis based on 3-dimensional (3D) ultrasound. Design：Derivate retrospectively and validate prospectively. Setting: University affiliated hospitals Population: 668 IUA in the derivation cohort and 426 IUA in the validation cohort. Methods: Logistic regression analysis was used to develop prediction models to forecast the live birth rate following HA according to postoperative 3D-TVUS characteristics and hysteroscopy characteristics. The performance of each of the prediction models was compared by calculating the area under the curve (AUC). A nomogram was then constructed for the excellent model. Main Outcome Measures: General clinical information, 3D-TVUS characteristics and hysteroscopy characteristics. Results: Live birth was achieved by 242 IUA patients in the derivation cohort (n = 668) and by 150 in the validation cohort (n = 426). Logistic regression analysis revealed that the AUC for the models based on 3D-TVUS characteristics in the derivation and validation cohorts were 0.8506 and 0.8963, respectively, which was better than the models based on hysteroscopy characteristics. The calibration curve of the nomogram based on 3D-TVUS characteristics and a non-significant Hosmer–Lemeshow test statistic showed good calibration (P = 0.3064). Conclusion: Our findings indicate that postoperative 3D ultrasound characteristics could be predictive factors for live births among IUA patients and provide valuable reproductive guidance for women after HA.