The invention discloses an ultrasonic guided puncture and nerve block auxiliary positioning device. The device comprises an adjusting mechanism and a positioning mechanism, the adjusting mechanism iscomposed of a supporting bed plate, a transverse sliding groove, a transverse lead screw, a transverse sliding block, a transverse motor, a reset groove, a headrest, a supporting table top, a displayscreen and a computer host; the transverse sliding groove is dug in one side of the supporting bed plate, the transverse lead screw is rotatably connected into the transverse sliding groove, the transverse sliding block is slidably connected into the transverse sliding groove, the transverse lead screw penetrates through the middle of the transverse sliding block, and the transverse lead screw isin threaded connection with the transverse sliding block. An infrared auxiliary device and a positioning mechanism are arranged; by combining computer integration, a puncture needle and a scanning section can reach a plane more easily, the development effect is improved, information is input in advance when a certain position needs to be punctured, the computer can give a prompt at the position closest to the puncture position, the puncture success rate is increased, and complications and anesthetic dosage are reduced.