The invention belongs to the technical field of non-destructive testing and measuring, and discloses a focusing rotary scanning photoacoustic ultrasonic blood vessel endoscope imaging device and a focusing rotary scanning photoacoustic ultrasonic blood vessel endoscope imaging method. The device comprises a photoacoustic ultrasonic endoscope imaging probe, a rotating connecting part and a peripheral circuit part, wherein pulse laser generates 90-degree reflection at the light outlet end and is irradiated on the blood vessel wall after being gathered by a cylindrical surface light gathering lens, photoacoustic signals are generated, a sound-sensitive element receives the photoacoustic signals, the photoacoustic signals are collected and recorded after being converted, the synchronous working of a data collector and a pulse laser is realized, triggering signals generated by the pulse laser trigger an ultrasonic pulse emitting and receiving device to emit electric signals, the electric signals trigger the sound-sensitive element to emit ultrasonic signals, the ultrasonic signals are reflected after reaching the blood vessels, are received by sound-sensitive elements and are collected and recorded after being converted, a step motor drives the device for carrying out scanning to obtain the whole blood vessel fault data, and photoacoustic and ultrasonic images are obtained after the processing. The sound-sensitive elements are shared by ultrasonic and photoacoustic images, and the high-resolution and high-sensitivity blood vessel internal ultrasonic photoacoustic imaging can be realized.