Abstract: Objective To evaluate the feasibility, safety and efficacy of ultrasound-guided catheter drainage via pelvic wall and deep vessels in deep pelvic lymphocyst after gynecological malignancies surgery. Methods A total of 82 deep pelvic lymphocysts in 75 patients from January 2017 to December 2018 after gynecological malignancies surgery, there is no safe catheter drainage approach via abdominal wall. Among them, there were 6 cases of lymphocyst without accompanied symptoms; 76 cases of lymphocyst with accompanied symptoms, including 45 cases of pain, 32 cases of fever, 12 cases of lower limb edema, 1 case of lower limb thrombus and 3 cases of hydronephrosis. The feasibility, success rate, complication and efficacy of the approach via pelvic wall and deep vessels were observed. Results Among 82 lymphocysts, 78 Lymphocysts had catheter drainage approach, the feasibility of this approach was 95.1%. During the operation, one case failed due to pelvic wall vessel hemorrhage and one case failed due to arteriae iliaca externa hemorrhage, the incidence of complications was 2.4%. Regarding the success rate of catheterization, all cases completed the operation except 2 bleeding cases. After catheterization, 3 patients' drainage tube were removed because of lower limb numbness, and all of them occurred in the initial stage of catheterization through this route. The success rate of catheter drainage was 93.9%. Postoperative follow-up showed that the diameter of all the asymptomatic lymphatic cysts was reduced by more than 1/2, among the symptomatic lymphatic cysts, 49 cases had disappeared symptoms, 15 cases had relieved symptoms, the effective rate of catheter drainage was 85.4%. Conclusion If there is no safe approach to catheter drainage for deep pelvic lymphocysts through abdominal wall, approach via pelvic wall and deep vessels can make most patients achieve catheter drainage, which is safe and effective, and is worthy of clinical promotion.