Objective To evaluate the clinical effect of supraclavicular fossa puncture in coracoid approach brachial plexus block under ultrasonic guidance.Methods Sixty patients scheduled for distal upper extremity surgery, male 33 and female 27, BMI 18.5-28.0 kg/m2, aged 18-60 years old, falling into ASA physical statusⅠ-Ⅲ, were randomly divided into groups A and B, 30 cases in each.Coracoid approach brachial plexus block was carried out under ultrasonic guidance.The puncturing point was located in infraclavicula (group A) or supraclavicular fossa (group B), and 0.5％ropivacaine 20 ml was injected around axillary artery for each patient.The procedure time and the number of needle adjustment were recorded as primary outcome, and the onset time, sensory block score at 15 min after injection, the success rate of block and the incidence of complications were noted also.Results Compared with group A, the procedure time was shorter in group B (P<0.05).There was no significant difference in the number of needle adjustment, onset time, sensory block score at 15 min, the success rate of block and incidence of complications between the two groups.Conclusion Puncturing through supraclavicular fossa can shorten the procedure time of coracoid approach brachial plexus block guided by ultrasound.It is effective and safe, and does not increase the complications.