Objective The aim of this study was to investigate the safety and efficiency of ultrasound guided arterial catheterization on the dorsalis pedis puncture. Methods Sixty patients who were scheduled for sinus operation with general anesthesia were randomized into two equal-sized groups: traditional palpation group (Group T) and ultrasound group (Group S). Group T catheterized using traditional method with forefinger to palpate dorsalis pedis pulse for surface localization and direction of needling, and Group S undergone a real-time bedside ultrasound-guided in-plane catheterization. The frequency of successful catheterization, the time of successful catheterization at the first time, the failure number of puncture catheterization attempts, the cause of the failure, the number of local Hematomas were recorded and compared between the two groups. Result There were no differences in age, body weight, sex composition between the two groups (P > 0.05). Compared with Group T, the number of puncture catheterization attempts were significantly higher(63.3% vs. 93.3%,P < 0.05), and the total success rate of catheterization were significantly higher in Group S (80% vs. 100%,P<0.05). The success rate of catheterization at the first puncture attampt was significantly higher in Group S than Group T (P < 0.05). The time required for successful catheterization at the first time in Group S was longer than Group T (P<0.05). There was significant difference in puncture site local hematomas between the Group T and Group S (8 vs. 1,P<0.05). Conclusion Ultrasound-guided dorsalis pedis arterial catheterization can effectively improve the success rate of puncture catheterization and decreases the number of puncture attempts for avoiding the complications such as local hematomas and tissue damage.