PURPOSE: To investigate the role of the resistive index measured with transvaginal color Doppler ultrasonography (TVCDUS) for assessing the radiotherapy response of cervical carcinoma and to compare it with magnetic resonance findings. MATERIALS AND METHODS: A total of 13 patients with advanced stage cervical carcinoma (>IIA) underwent magnetic resonance imaging (MRI) and TVCDUS exams 6 months prior to and 6 months after radiotherapy. Pre- and post-treatment resistive indices obtained from the central and peripheral zones of the tumor were compared. These values were also compared with MRI findings and resistive indices obtained from the control group. RESULTS: Tumoral masses could be visualized in all patients with B-mode TVCDUS prior to the treatment. Resistive indices before and after treatment were 0.20-0.82 (mean: 0.52+/-0.15), and 0.70-0.99 (mean: 0.81+/-0.14), respectively. Eleven out of 13 patients responded to the treatment completely and no mass was detected in MRI and TVCDUS. Investigations were performed in areas with flow within the tumor-free cervix. A residual mass was noted in 2 patients with MRI and TVCDUS. There was a statistically significant difference between complete response to the treatment and increased resistive indices (P=0.001). In 2 patients with residual masses, no increase in resistive indices was detected. The mean resistive index of the control group was 0.65+/-13 and the difference was statistically significant compared to the resistive indices of the patients prior to the treatment. CONCLUSION: Since there was a significant correlation between the MRI findings and resistive indices, the spectral parameters obtained with TVCDUS were a good alternative to such an expensive modality as MRI in the evaluation of the response of cervical cancer to the treatment.