Objective To investigate the analgesic effect of ultrasound guided anterior and quadratus lumborum block at the lateral supra-arcuate ligament after laparoscopic renal cyst decompression. Methods 99 patients with renal cyst undergoing selective laparoscopic decompression were selected and randomly divided into general anesthesia group (G group), general anesthesia with anterior quadratus lumborum block group (Q group) and general anesthesia with anterior quadratus lumborum block at the lateral supra-arcuate ligament group (QA group). Nerve block was performed before anesthesia induction. The recorded indexes include dosage of sufentanil 24h after operation, first press time of analgesia pump, intraoperative remifentanil dosage, VAS scores with quiet and cough at each time point after extubation, cases of rescue analgesia within 24 hours after operation, recovery quality scores 24h after operation, lower limb muscle strength, incidence of postoperative nausea and vomiting, infection, hematoma, subcutaneous emphysema and shoulder pain. Results The dosages of sufentanil 24h after operation in group Q and QA were lower than that in group G, group QA was lower than group Q(P<0.05). The first press time of analgesia pump in group Q and QA were later than that in group G, group QA was later than group Q (P<0.05). The VAS scores of patients in group Q and QA were lower than those in group G, the VAS scores in group QA was lower than that in group Q with quiet at T7~T9 time points(P<0.05), the VAS scores in group QA was lower than that in group Q with cough at T8~T9 time points(P<0.05). There was no significant difference in the incidence of postoperative nausea and vomiting, infection, hematoma, subcutaneous emphysema and shoulder pain in the three groups(P>0.05). Conclusion For patients undergoing laparoscopic renal cyst decompression, the analgesic effect of anterior quadratus lumborum block at the lateral supra-arcuate ligament is better than that of anterior quadratus lumborum block, which can significantly reduce the dosage of opioids and prolong the analgesic time