Objective: To present our experience in assessing tumor vascularity in advanced cervical cancer using the HDlive flow silhouette mode. Materials and methods: Thirteen advanced cervical cancer patients (11 squamous cell carcinoma (SCC) patients and 2 gastric-type mucinous carcinoma (GAS) patients) were studied using the HDlive flow silhouette mode. Tumor vascularity was assessed using the subjective grading system (grade I, minimal blood flow pattern; grade II, moderate blood flow pattern; and grade III, abundant blood flow pattern). Results: The number of patients with grade I was 0, that of grade II was 4 (36.4%), and that of grade III was 7 (63.6%) in the SCC group, whereas that of grade I was 2 (100%) in the GAS group (p = 0.0128). Conclusion: Tumor vascularity may differ between SCC and GAS advanced cervical cancers. A grading system using the HDlive flow silhouette mode may provide useful, additional information on the assessment of tumor vascularity in the treatment effect on advanced cervical cancers. Further studies involving a larger sample size are needed to confirm the validity of this grading system using the HDlive flow silhouette mode for the assessment of tumor vascularity in advanced cervical cancer patients.