〔Abstract〕 Objective To investigate the effect of nerve block guided by B-ultrasound in clinical anesthesia. Methods From January 2020 to February 2021, 74 patients undergoing elective surgery admitted to the People's Hospital of Huiji District, Zhengzhou City were selected as the research objects, and the patients were randomly divided into a control group and an observation group with 37 cases each.The control group received anesthesia under traditional brachial plexus blind exploration, and the observation group received nerve block anesthesia guided by B-ultrasound. The anesthesia effects of the two groups were compared. Results The excellent and good rate of anesthesia in the observation group was 97.3%, which was higher than 83.8% in the control group. The difference was statistically significant (P < 0.05). The visual analogue scale (VAS) scores of the observation group were all at each time point after surgery. Lower than the control group, the difference was statistically significant (P < 0.05); the dose of lidocaine in the observation group was (25.0 ± 2.3) mL, which was significantly lower than the control group (38.5 ± 3.7) mL, the difference was statistically significant Significance (P < 0.05). Conclusion The use of ultrasound-guided nerve block in clinical anesthesia can achieve an ideal anesthesia effect, and can reduce the dosage of anesthetic drugs and effectively reduce the pain of patients.