Objective To compare the effects of ultrasound-guided interscalene approach and axillary artery approach of brachial plexus block in distal radius fracture surgery.Methods A total of 106 patients undergoing distal radius fracture surgery in our hospital from January to December 2018 were selected and divided into two groups by random number table, with 53 cases in each group.All selected cases received brachial plexus block, the observation group was given ultrasound-guided axillary artery approach, and the control group was given interscalene approach.The disappearance time of neuralgia, anesthetic effect, and complications in the two groups were observed.Results The neuralgia disappearance time of medial cutaneous nerve of forearm, median nerve, and ulnar nerve in the observation group [(10.18±4.32) min, (13.50±7.06) min, and (8.13±4.27) min] were shorter than the time of the control group [(18.04±6.79) min, (19.72±8.14) min, and (21.16±6.39) min]; the rate of successful anesthesia in the observation group (90.57%) was higher than that in the control group (69.81%); and the rate of anesthesia failure in the observation group (3.77%) was lower than that in the control group (15.09%) (P<0.05).There were no statistical differences in the neuralgia disappearance time of lateral cutaneous nerve of forearm and musculospiral nerve and the incidence rate of complications between the two groups (P>0.05).Conclusion Ultrasound-guided axillary artery approach of brachial plexus block for patients with distal radius fracture surgery produces less complications and good anesthetic effect, which can increase the effect of nerve block.