Objective: To compare the clinical effect of radial artery puncture and catheterization in ultrasound-guided short-axis, long-axis and oblique-axis planes. Methods: A total of 120 patients undergoing radial artery puncture and catheterization in the hospital were enrolled as the research objects between May 2023 and May 2025. According to random number table method, they were divided into control group (group D, blind puncture), short-axis group (group S, ultrasound-guided short-axis puncture), long-axis group (group L, ultrasound-guided long-axis puncture) and oblique-axis group (group O, ultrasound-guided oblique-axis puncture), 30 cases in each group. The imaging time of ultrasound positioning among group S, group L and group O, as well as clinical indexes (success rate of the first puncture and catheterization, total spending time of successful puncture and catheterization, the first success time of puncture, the first time of successful puncture and catheterization), effect of puncture and catheterization, and puncture complications among the four groups were compared. Results: The imaging time of ultrasound positioning in group S was shorter than that in group L and group O (P<0.05). The success rate of the first puncture and catheterization in group S, group L and group O was higher than that in group D, total spending time of successful puncture and catheterization, the first success time of puncture and the first time of successful puncture and catheterization were shorter than those in group D. Moreover, total spending time of successful puncture and catheterization and the first success time of puncture in group O were shorter than those in group S and group L, and the first time of successful puncture and catheterization was shorter than that in group S (P<0.05). The good rate of puncture and catheterization in group S, group L and group O was higher than that in group D (P<0.05), and incidence of puncture complications was lower than that in group D (P<0.05). Conclusion: The effect of ultrasound-guided radial artery puncture is superior to that of traditional blind puncture, which can increase success rate of the first puncture and shorten the time of puncture and catheterization. Compared with short-axis and long-axis planes, radial artery puncture and catheterization in ultrasound-guided oblique axis plane has more advantages.