【Abstract】Objective：This study aims to investigate the technical nuances and clinical effects of intraoperative ultrasonic-guided resection of deep-seated intracranial cavernous malformation. Methods: The clinical data of 45 patients with cavernous vascular malformation were retrospectively analyzed and divided into the ultrasound-guided group (26 cases) and control group (19 cases) according to whether ultrasound guidance was used during operation. General information and ultrasound images were recorded. The diameter (mm) and depth (mm) of each case, operation time under the microscope (min)， and hospitalization period(d) of the two groups were compared. KPS scores were compared between the two groups before surgery, one week after surgery, and three months after surgery respectively. Results: Deep-seated cavernous malformations and surrounding structures had typical ultrasonic imaging characteristics. The two groups had a similar clinical backgrounds in diameter, depth, and preoperative KPS score (P＞0.05). Compared with the control group, the operation time under the microscope (41.69±8.04) min, hospitalization period (6.92±1.57) d, and KPS score (65.38±7.60) one week after operation in the ultrasound group were significantly decreased (P＜0.05). However, there was no statistical difference in KPS scores three months after surgery (88.46±8.34) vs (87.36±12.84) between the two groups (P＞0.05). Conclusion: Ultrasound can help to reach the lesion quickly and accurately, thus shortening the operation time and hospitalization period, improving the surgical efficacy, and promoting the rapid recovery of patients.