OBJECTIVE To discuss the diagnostic value of bedside ultrasound on patients with severe multiple chest injury in intensive care unit(ICU). METHODS 120 cases of patients with severe multiple injury which was taken as research objects in ICU of our hospital from April 2018 to March 2019. All the patients were detected by ICU physicians with bedside ultrasound and the patients were detected by X-ray within 2h after ultrasound examination. The diagnostic results of CT examination or surgical exploration were taken as gold standard, the inspection time, diagnostic results and diagnostic efficiency of bedside ultrasound and X-ray was observed. Multivariate regression analysis was performed on the diagnostic efficiency of bedside ultrasound. RESULTS The inspection time of bedside ultrasound and X-ray was (4.1±1.5)min, (19.0±3.3)min, respectively and the inspection time of bedside ultrasound was significantly shorter than that of X-ray( ^P<0.05). 120 patients were confirmed as 60 positive patients by CT examination or surgical exploration and 28 patients combined with pleural effusion, 12 patients combined with pulmonary contusion, 7 patients combined with pneumothorax, 3 patients combined with traumatic diaphragmatic hernia. The correct diagnostic coincidence rate of bedside ultrasound on pleural effusion (92.86% vs 71.43%), pulmonary contusion (83.33% vs 50.00%), pneumothorax (90.00% vs 50.00%), pericardial effusion (100.00% vs 14.29%) was significantly higher than that of X-ray (P<0.05).54 positive patients and 66 negative patients were check out by bedside ultrasound, 49 positive patients and 71 negative patients were check out by X-ray, the consistency of diagnostic results of bedside ultrasound was significantly higher than that of X-ray( ^P<0.05).