Timely diagnosis of PID is crucial for effective management, and leveraging ultrasound can enhance this process. Acute PID presents diagnostic challenges due to its variable symptoms, which can be subtle or nonspecific, and may even be asymptomatic. These factors often lead to delays in diagnosis and treatment, contributing to inflammatory complications in the upper genital tract. While laparoscopy offers a more precise diagnosis, its limited availability and inability to detect all forms of PID make it less practical for timely management. However, Transvaginal sonography (TVS) can be a valuable tool in this regard, offering a non-invasive and accessible method for evaluating pelvic inflammatory changes. By utilizing ultrasound alongside clinical assessment, healthcare providers can improve the timeliness of PID diagnosis, leading to more effective management and reduced risk of complications.