Objective Exploring the application effect of ultrasound-guided spinal anesthesia in obese parturients. Methods A total of 96 obese parturients who gave birth at Changzhou Traditional Chinese Medicine Hospital in Jiangsu Province from June 2022 to June 2024 were selected for the study. After excluding dropouts, a total of 90 parturients were selected and divided into a control group and a study group, with 45 cases in each group. The control group received traditional palpation guided spinal anesthesia, while the study group received ultrasound guided spinal anesthesia. Compare the puncture situation, vital signs, anesthesia effect, neonatal Apgar score, and complications between the two groups. Results Number of punctures, preparation before anesthesia, puncture, and onset time in the study group were shorter than (P<0.05). At 10 min after anesthesia, diastolic, systolic, and heart rate were lower than the control group (P<0.05)..The VAS score of the study group at 2 hours, 4 hours and 6 hours was lower than that of the control group (P<0.05).The proportion of anesthesia grade Ⅰ patients in the study group was relatively high (P<0.05). Neonates with 1,5 and 10 min Apgar scores were higher than the control group (P<0.05). Conclusions Ultrasound assisted spinal anesthesia is used during delivery for obese mothers, which can shorten the onset time, reduce the number of punctures, and suppress postoperative complications. It has a good clinical effect.