Objective To evaluate the drainage effectiveness and adverse effects of ultrasound-guided pigtail catheterization on malignant pleural effusion. Method A retrospective analysis of patients with malignant pleural effusions and indwelling pleural catheter drainage admitted to Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January to June 2022 was performed. 147 patients were included in this study, and divided into control group (central venous catheter, n= 68) and study group (pigtail catheter, n=79) according to different drainage catheters．The operation time of catheterization, complication rate, displacement rate, obstruction rate and total effective rate were compared between the two groups. Results In the control group, the operation time of catheterization, complication rate, displacement rate, obstruction rate and total effective rate were: (16.8 ± 1.6) min, 1.5%, 1.5%, 11.8% and 86.8%, respectively. In the study group, the operation time of catheterization, complication rate, displacement rate, obstruction rate and total effective rate were:（18.9±2.4）min、1.3%、2.5%、2.5%、94.9%, respectively. Compared with the control group, the study group had a slightly longer operation time of catheterization and a lower obstruction rate, with statistically significant differences (P <0.05). No statistically significant (P> 0.05) existed in terms of the complication rate, displacement rate and total effective rate. Conclusion Both central venous catheter and pigtail catheter achieved remarkable effect in the drainage of patients with malignant pleural effusion in this study. Benefit from a lower obstruction rate, the pigtail catheter is worthy of wide clinical application.