Objective To evaluate the enhancement effect of microbubble contrast agent on the accuracy of ultrasound-guided microwave ablation for hemostasis and the hemostatic efficacy in a porcine traumatic liver hemorrhage model. Methods A randomized controlled animal trial was conducted utilizing 24 miniature pigs (weight: 30-50 kg). Following establishment of a standardized liver injury model, subjects were randomly allocated to either a microbubble contrast agent group (n=12, receiving intravenous SonoVue at 0.1 ml/kg) or a saline control group (n=12, administered an equivalent volume of saline). Both groups were treated with KY2000 microwave therapy instrument (power 60 W) for ablation hemostasis under ultrasound guidance. Hemodynamic parameters-including heart rate, mean arterial pressure, and rectal temperature-were monitored continuously throughout the procedure. Postoperative liver dissection and histopathological examinations were performed. Results The experimental results showed that in the ultrasonographic examination, the group using microbubble contrast agents exhibited significantly enhanced echo intensity in the hemostatic area, with markedly improved clarity of the boundaries adjacent to normal liver tissue, facilitating precise intraoperative localization of the bleeding site. The microwave needle under ultrasound guidance rapidly reached the center of the bleeding site, with an average hemostasis time of approximately 3±0.32 minutes across different liver regions. In areas adjacent to the hepatic artery, the coagulation time in the microbubble contrast agent group was significantly shorter than that in the control group [(5.50±0.52)min vs. (9.67±0.85)min, P<0.001]. However, in regions near the diaphragm and gallbladder, there was no statistically significant difference in coagulation time between the two groups. Intraoperative physiological parameter monitoring revealed no statistically significant differences in heart rate, mean arterial pressure (MAP), or rectal temperature between the two groups. Nevertheless, analysis of blood pressure trends indicated that the microbubble contrast agent group had smaller fluctuations in systolic and diastolic blood pressure, suggesting a more stable hemodynamic state. Laboratory tests 24 hours postoperatively showed that the decrease in hemoglobin, reduction in platelet count, and total blood loss in the microbubble contrast agent group were significantly lower than those in the control group (P<0.05). Pathological examination revealed that both groups formed spindle-shaped coagulative necrosis zones [diameter (1.52±0.15) cm] after microwave ablation. Under optical microscopy, the degree of hepatic sinus congestion and dilation was more pronounced in the microbubble contrast agent group. Conclusions In a porcine model of traumatic liver hemorrhage, microbubble contrast agent can significantly enhance ultrasonographic visualization of the bleeding site, improve localization accuracy, and effectively abbreviate microwave ablation hemostasis time in critical areas such as the adjacent hepatic artery, thereby enhancing overall hemostatic efficiency.