Objective To explore the curative effect of ultrasound-guided puncture cystic wall ablation on thyroid benign cystic solid nodules and its influences on nodules volume and incidence of complications. Methods A retrospective analysis was performed on the 102 patients with thyroid benign cystic solid nodules admitted to the hospital from January 2016 to January 2021. According to different surgical methods, they were divided into puncture cystic wall ablation group (57 cases, ultrasound-guided puncture cystic wall ablation) and percutaneous ethanol injection (PEI) group (45 cases, PEI). The reduction rate of benign cystic solid nodules between the two groups was compared after surgery. Before and after surgery, levels of serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) in both groups were detected by full-automatic biochemical analyzer. Before and after surgery, levels of serum interleukin-6 (IL-6) and C-reactive protein (CRP) in both groups were detected by enzyme-linked immunosorbent assay (ELISA). After surgery, postoperative complications in both groups were statistically analyzed.Results At 2 months after surgery, the reduction rate of nodules in puncture cystic wall ablation group was significantly higher than that in PEI group (P<0.05). At 1 month after surgery, the levels of serum FT3 and FT4 in puncture cystic wall ablation group were significantly higher than those in PEI group (P<0.05), and the TSH level was significantly lower than that in PEI group (P<0.05). At 1d after surgery, the levels of serum CRP and IL-6 in puncture cystic wall ablation group were significantly lower than those in PEI group (P<0.05). At 1 month after surgery, total incidence of complications in puncture cystic wall ablation group was significantly lower than that in PEI group (P<0.05). Conclusion Compared with PEI, ultrasound-guided puncture cystic wall ablation can promote reduction of nodules volume, improve thyroid function, reduce levels of inflammatory factors and complications.