The invention relates to a shoal sea area rescue operational ship with a pile driving and pulling device. A through hole allowing driving and pulling of a pile is arranged on a deck of an operational ship body, a hollow hoisting truss is fixedly connected on the ship body deck at the upper edge of the through hole, the vertical pile is suspended in the hoisting truss, racks are symmetrically and longitudinally arranged on the lateral side of the outer surface of the pile, and a lifting mechanism which drives the pile to reciprocate longitudinally and enable the pile to be driven in or pulled out of the seabed is meshed with the racks. By means of driving of the pile by the pile driving and pulling device arranged on the ship body, the ship body can be stably fixed to a shoal sea area to set rescue equipment, personnel and corresponding goods and materials down, and after rescue is finished, the ship body can be unfixed to sail freely by means of pulling of the pile by the pile driving and pulling device. The deck of the fixed rescue ship body can serve as a reliable operating platform.