Objective: To investigate the diagnosis of senile sarcopenia by multi-modal ultrasound parameters and its therapeutic effect. Method: Eighty-four senile patients with sarcopenia diagnosed and treated from August 2019 to March 2022 were selected as the study object and set as the observation group, while 42 healthy elderly patients were selected as the control group during the same period. Ultrasonography was performed to compare the muscle thickness, pinniform Angle, muscle bundle length and Young"s modulus under relaxed and contracted conditions. The total effective rate after routine western medicine and elastic band training was observed, and the score of grip strength, ASMI and SPPB at admission, 1, 3 and 6 months after intervention. The AUC value, sensitivity and specificity of muscle thickness, pinniate Angle, muscle bundle length and Young"s modulus in diagnosing sarcopenia and predicting curative effect were analyzed by ROC curve model. Results: The muscle thickness, pinniate Angle and muscle bundle length in observation group were lower than those in control group (P < 0.05). Young"s modulus of relaxation and contraction in observation group were lower than those in control group (P < 0.05). Diagnostic efficacy: The AUC values of muscle thickness, pinniform Angle, muscle bundle length, Young"s modulus and multimodal ultrasonic parameters for diagnosing sarcopenia were 0.775, 0.716, 0.621, 0.749, 0.911, P < 0.05, respectively. The total effective rate of 84 cases of senile sarcopenia after treatment was 86.90%, of which 44 cases (52.38%) were significantly effective, 29 cases (34.52%) were effective, and 11 cases (13.09%) were ineffective. The grip strength, ASMI and SPPB scores at 1, 3 and 6 months after intervention were higher than those at admission (P < 0.05). Predictive efficacy: The AUC values of muscle thickness, pinniate Angle, muscle bundle length and Young"s modulus for predicting the efficacy of sarcopenia were 0.805, 0.846, 0.785, 0.775, P < 0.05. Conclusion: Multi-modal ultrasound parameters have high clinical value in the diagnosis of senile sarcopenia, and can also provide objective guidance for the evaluation of the treatment effect of sarcopenia.