Objective To investigate the clinical value of ultrasound-guided thrombin injection (UGTI) in the treatment of iatrogenic femoral artery pseudoaneurysms (IFAP) with femoral arteriovenous fistulas. Methods Thirty-two patients with IFAP after coronary artery intervention were selected, among whom 9 were complicated with femoral arteriovenous fistulas. All patients were treated with UGTI, and underwent ultrasound examinations 3 d, 14 d and 30 d after treatment. Results Successful treatment was achieved in 31 patients, while the other patient failed and subjected to surgery. No recurrence of IFAP and no complications were found during follow up in 31 cases. Conclusion UGTI has a high clinical value for the treatment of IFAP, and is a safe and effective therapy for those complicated with femoral arteriovenous fistulas.