Objective To explore the diagnostic value of ultrasonography for musculoskeletal injuries of soldiers in long-distance sailing. Methods A total of 182 soldiers in Chinese navy escort fleets in Aden Gulf were selected, and the pain, swelling and discomfort parts of joint and/or soft tissue were examined by ultrasound. Results Forty-one soldiers were examined, and 29 cases were positively diagnosed. There were 17 cases of knee joint cavity effusion (11 cases on one side and 6 cases on both sides), of which 4 cases were accompanied by ligament bursitis (2 cases of inferior patellar ligament bursitis, 1 case of lateral collateral ligament bursitis, and 1 case of subcutaneous deltoid ligament bursitis of ankle joint); 7 cases of soft tissue injuries, including 4 cases of subcutaneous superficial soft tissue injuries, 2 cases of tendon injuries, and 1 case of muscle injury; 2 cases of soft tissue infection; 1 case of tendon sheath cyst; 1 case of tibial tubercle osteochondrosis; and 1 case of hyperplasia of the extensor tendon sheath trauma after injury. Conclusion Ultrasound is suitable for early diagnosis, differential diagnosis and efficacy evaluation of common musculoskeletal injuries in long-distance sailing.