Abstract Abdominal entry at the time of laparoscopy remains the most critical step in laparoscopic surgery. Transabdominal ultrasound (TAU) and cine magnetic resonance imaging (cine-MRI) are both non-invasive tools in the preoperative prediction of adhesions. Ultrasound is effective in detecting abdominal wall adhesions, but MRI is the best for intra-abdominal adhesions. Periumbilical ultrasound-guided saline infusion (PUGSI) is an excellent method for detecting subumbilical adhesions. Evaluate the most effective and rapid method for diagnosis of subumbilical adhesions before laparoscopic interference in gynecological practice. This study was carried out on 90 high-risk patients for subumbilical adhesions. All patients were subjected to medical history, physical examination, laboratory investigations, and three techniques for subumbilical adhesions detection before laparoscopic entry including cine-MRI, TAU, and PUGSI. PUGSI for detection of subumbilical adhesions showed that the sensitivity of 94.7 % and a specificity of 90.1 %. With preoperative TAU, a sensitivity of 89.5 % and a specificity of 88.7 % were obtained. With cine-MRI, a sensitivity of 78.9 % and a specificity of 84.5 % were obtained. PUGSI is a more sensitive and rapid method than TAU and cine-MRI for detection of subumbilical adhesions before laparoscopic gynecological surgery.