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The application provides an ultrasound-guided puncture method and system, relates to a data processing technology, and achieves accurate positioning during venous puncture under ultrasound guidance by constructing a part model corresponding to a puncture part, determining a partition scanning line of the part model, controlling an ultrasound device to perform segmented scanning on the puncture part based on the partition scanning line, obtaining a segmented scanning image, determining a segmented scanning image meeting a puncture condition as a sub-adaptive image, performing splicing processing on adjacent sub-adaptive images to obtain a spliced puncture image, performing venous shape judgment on the spliced puncture image to obtain a candidate puncture image, performing optimal selection on the candidate puncture image to obtain a puncture guide image, and determining a puncture point of a punctured vein in the puncture guide image based on a centripetal direction.