Objective To explore the effect of ultrasound-guided supraclavicular brachial plexus block on elderly patients with upper limb fracture surgery. Methods A total of 100 elderly patients with upper limb fracture surgery from January 2019 to January 2021 were selected as study subjects. They were divided into a traditional method group （n=50） and an ultrasound-guided group （n=50）. Comparisons were made in anesthesia effect, block onset time of the main brachial plexus branches, complete block rate within 30 min, and the occurrence of complications between the two groups. Results The excellent and good rate of anesthesia in the ultrasound-guided group was higher than that in the traditional method group （P<0.05）. The ultrasound-guided group showed shorter block onset time of the ulnar nerve, median nerve, musculocutaneous nerve, and radial nerve block than the traditional method group （P<0.05）, and higher complete block rates of the ulnar nerve and median nerve within 30 min （P<0.05）. No significant difference was found in the complication rate between the two groups （P>0.05）. Conclusion The effect of ultrasound-guided supraclavicular brachial plexus block for elderly patients with upper limb fracture surgery is better than the block with acupuncture positioning. The former method can shorten the onset time of anesthesia block, increase complete block rate within 30 min, and has high safety.