Ultrasound guided axillary vein puncture catheterization has significant advantages over traditional palpation blind puncture method, which can improve the success rate of puncture catheterization and reduce the incidence of adverse reactions. However, different ultrasound-guided axillary vein puncture catheterization techniques have their own advantages and disadvantages, as operational skills may lead to risks such as hematoma and spasms. The article describes the operating method, factors affecting the success rate, and related complications of ultrasound-guided axillary vein puncture catheterization. The clinical application of real-time ultrasound guidance still requires in-depth research and continuous exploration to fully realize its medical value.