Objective To study the guidance value of high-frequency combined with superficial small organs probe and cavity probe in surgery of perianal abscess. Methods The clinical data of 110 patients with perianal abscess with anal fistula through primary radical treatment and ultrasonic examination were analyzed. According to surgical findings, the ultrasound imaging characteristics and cure rates for different ultrasonic examination method were compared. Results The diagnostic coincidence rates were 73.8%(31/42) and 57.1%(24/42) for fistula internal orifice and the direction of the fistula in high-frequency superficial probe, were 94.5%(52/55) and 90.9%(50/55) in the combined use of high-frequency superficial and cavity probe, one-time cure rates were 64.2% and 93.0%, respectively. Compared between combined use of simple probe and high-frequency probe, not only perianal abscess with anal fistula , the diagnostic coincidence rate but also one-time cure rate, the difference had statistical significance (P<0.05). Conclusions It is of high guidance value to surgery of perianal abscess in combined use of high-frequency superficial small organs probe and cavity probe.