Objective:To investigate the characteristic features of gastric motility dysfunction in patients with hypothyroidism (HT)andtoquantitativelyexploretheirassociation withthyroidhormonelevels.Methods:Atotalof83 patientswithhypothyroidism (subgroupedbyetiologyintoHashimoto??sthyroiditis,post- 131Itherapy,andpost-thyroidectomy) and58 healthycontrols wereenrolled.Gastricfilling ultrasonography (GFU)wasperformedtoobtain gastric motility parameters,includinggastricaccommodation,contractionfrequency,peakamplitudeofcontraction waves,contraction wave velocity,gastricmotilityindex(GMI),antralcontractionamplitude(ACA),andgastricemptyingratesatmultipletimepoints (GER).Gastrointestinalsymptom scores (GSRS)andthyroidfunctionlaboratoryindicators [serum thyroid-stimulating hormone(TSH),freetriiodothyronine(FT3),andfreethyroxine(FT4)]weresimultaneouslycollected.Spearmancorrelation analysiswasusedtoassesstheassociationsbetween TSH levels,GSRSscores,andgastric motilityparameters.Results: Comparedwithhealthycontrols,thehypothyroidgroupexhibitededucedcontractionfrequency,peakamplitudeofcontraction waves,contractionwavevelocity,GMI,gastricemptyingratesatmultipletimepoints,andACA (P<0.05).Subgroupanalysis showedthatthepost- 131Itherapyandpost-thyroidectomygroupshadreductionsincertainparameters(proximalGERat10min andACAat10 min,P<0.05).SpearmancorrelationanalysisrevealednegativecorrelationsbetweenTSHlevelsandGMI, contractionfrequency,proximalGERat30min,andACAat30min(P<0.05).GSRSscoreswerealsonegativelycorrelated withGMIandACAat30min(P<0.05).Conclusion:Patientswithhypothyroidismexhibitmultidimensionalgastricmotility dysfunction,whichisassociated with decreasedthyroid hormonelevelsand gastrointestinalsymptoms.Gastric motility abnormalitiesvaryaccordingtotheetiologyofhypothyroidism.Multiparametric,non-invasiveGFU providesanoveltoolfor preciseassessment,providing evidenceforindividualized clinicalinterventions,improving quality oflife,andfacilitating mechanisticunderstandingandmanagement.