Objective: To explore the clinical value of ultrasonic endoscopy in the diagnosis and treatment of patients with early gastrointestinal cancer. Methods: Select 74 patients with early gastrointestinal cancer admitted in our hospital during 2018.1 to 2020.5, retrospectively analyze the clinical data of these 74 patients, and divide them into a control group (34 cases, white light endoscopy + pigment staining) according to different diagnosis and treatment methods and min-probe sonography (MPS) group (40 cases, small probe ultrasound endoscopy), patients in both groups received endoscopy 1 to 2 weeks after receiving endoscopic ultrasonography (EUS)/MPS endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), with the final surgery and pathological examination results as the gold standard, observe the two types of ultrasound endoscopic diagnosis of disease compliance, lesions diagnosis accuracy rate in terms of location, lesion diameter, and tissue differentiation type, to assess the pain of the two groups of patients during the examination, and to count the occurrence of complications such as bleeding and perforation during the entire diagnosis and treatment process. Results: Compared with the control group in MPS group, there was no significant difference in the diagnostic coincidence rate between the two groups of disease types (P>0.05). There was no significant difference in the diagnosis accuracy of lesion diameter and tissue differentiation type (P>0.05). The accuracy of location diagnosis was significantly higher than that of the control group (P<0.05). The incidence of pain in the MPS group during the examination was significantly higher than that of the control group (P<0.05). The incidence of complications during the entire diagnosis and treatment period was significantly lower in the MPS group than in the control group (P<0.05). Conclusion: The use of ultrasound endoscopy in the diagnosis and treatment of gastric cancer, colorectal cancer and other gastrointestinal cancer patients has the advantages of high diagnosis accuracy and few occurrences, and the patients are better tolerated and can be preferred.