In order to investigate the anesthetic effect and safety of the ultrasound-guided brachial plexus block in pediatric upper limb surgery, this study retrospectively analyzed the anesthetic effect of the ultrasound-guided brachial plexus block in pediatric upper limb surgery. From January 2016 to December 2017, 82 children undergoing upper limb surgery in hospital A were selected and randomly divided into two groups by the coin method, with 41 children in each group. Ultrasound-guided brachial plexus block anesthesia and conventional anatomic localization brachial plexus block anesthesia were performed. The anesthetic drug dosage of sensory block at anesthesia completion time and motor block at onset time was compared between the two groups; the one-time puncture success rate and incidence of anesthesia complications were compared between the two groups (local anesthesia poisoning, nerve injury, pneumothorax, hematoma, and phrenic nerve palsy). The results showed that the anesthesia completion time in the study group was slightly longer than that in the control group. The sensory and motor block occurred earlier in the study group than in the control group. Low doses of narcotic drugs are used. The one-time puncture success rate of the study group was higher than that of the control group. The incidence of anesthesia complications was lower than that of the control group. The one-time puncture success rate was 92.8% in the study group and 75.7% in the control group. Ultrasound-guided brachial plexus block anesthesia has a significant effect in pediatric upper limb surgery, which can improve the anesthetic effect and reduce the incidence of complications, and is worthy of clinical promotion.