Objective To investigate the effect of ultrasound-guided puncture in the treatment of liver abscess. Methods A total of 80 patients with liver abscess in Putian Medical District of the 900 Hospital of the Joint Logistics Support from January 2019 to January 2021 were selected as the research object. They were randomly divided into observation group and control group with 40 patients in each group. The observation group was treated with ultrasound-guided puncture, and the control group was treated with incision and catheter drainage. The treatment effect, operation related indexes and postoperative complications were compared between the two groups. Results The total effective rate index of treatment in the observation group was higher than that in the control group, and the difference was statistically significant (P＜0.05). The time for white blood cells to return to normal index value, time for body temperature to return to normal index value, postoperative extubation time and total hospitalization time in the observation group were shorter than those in the control group, and the differences were statistically significant (P ＜0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P ＜0.05). Conclusion For the treatment of patients with liver abscess, ultrasound-guided puncture has the advantages of less trauma, good curative effect and low incidence of complications.