Objective To analyze the effect of ultrasound assistance in abdominal liposuction for shaping firm abs. Methods A total of 60 patients who underwent abdominal liposuction for firm abs shaping in Hangzhou Xingguang Beaucare Technology Co., Ltd. Medical Beauty Clinic from January 2022 to December 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the experimental group, with 30 patients in each group. The control group received conventional liposuction, and the experimental group received liposuction under ultrasound assistance. The liposuction effect, psychological status, satisfaction and adverse reactions were compared between the two groups. Results After intervention, the upper and lower abdominal circumferences of the experimental group were lower than those of the control group (P <0.05). After intervention, the scores of SAS and SDS in the experimental group were lower than those in the control group (P <0.05). The satisfaction rate of the experimental group was 96.67%, which was higher than 70.00% of the control group (P <0.05). The incidence of adverse reactions in the experimental group (3.33%) was lower than that in the control group (26.67%) (P <0.05). Conclusion Liposuction under ultrasound assistance has a good effect in shaping firm abs, with better psychological status, higher satisfaction, and higher treatment safety, which is worthy of clinical application.