Gallbladder perforation is a serious complication of acute cholecystitis. It mainly occurs after acute suppurative inflammation of the gallbladder associated with cholelithiasis. Its morbidity and mortality are very high. Enhanced ultrasonography (EUS) is a dynamic real-time imaging technique for monitoring the microflow of organs or tumors. It has been used in the evaluation of gallbladder diseases in recent years, including the identification of gallbladder tumors and the evaluation of the integrity of gallbladder wall. In this case, by observing the blood supply of the gallbladder wall and the integrity of the gallbladder wall, enhanced ultrasound can timely and accurately judge the occurrence of gallbladder perforation, and under the guidance of ultrasound, percutaneous transhepatic gallbladder puncture and drainage can quickly relieve the symptoms of patients and prevent the deterioration of the disease.