Patient Mr. Luo, a patient recovering from cerebral infarction, developed pain and discomfort in the shoulder joint on the affected side for some unknown reason about 2 weeks after the cerebral infarction. No one could touch it, and he could not exercise or work out. The pain in the shoulder joint was particularly intense, and he could not sleep at night and was emotionally irritable. The rehabilitation department found and gave musculoskeletal ultrasound examination and diagnosed: “Post-stroke shoulder pain Biceps long head tendonitis Inferior posterior muscle tendonitis”. Local injection treatment was given under ultrasound guidance. After the injection, the patient’s shoulder pain disappeared with activity at that time, and no more shoulder pain occurred in bed that night, and none of the rehabilitation treatments were performed to cause pain. After the disappearance of shoulder pain, the patient is now able to devote himself to rehabilitation treatment and is highly motivated to participate in treatment. Shoulder pain is one of the common complications of stroke, occurring in about 70% of patients 2-4 weeks after the onset of stroke. The pain makes it difficult for patients to undergo rehabilitation and further development will lead to more severe shoulder deformity, capsular adhesions, and aggravation of upper limb flexion spasticity pattern, thus seriously hindering the improvement of upper limb function. Therefore, identifying the cause of the patient’s shoulder pain and treating it appropriately is the key to the patient’s upper limb rehabilitation training. Using advanced musculoskeletal ultrasonography, the Rehabilitation I Department can find the cause of post-stroke shoulder pain more clearly. The examination can reveal long head biceps tendonitis, subacromial bursitis, shoulder capsulitis, rotator cuff injury, supraspinatus tendonitis and so on. The literature shows that the detection rate of subacromial bursitis, long head biceps tendonitis, and rotator cuff injury in patients with post-stroke shoulder pain is high. We carry out ultrasound-guided local injections according to different etiologies, and combine them with rehabilitation and physical therapy. After treating more than ten patients, the results are remarkable. Ultrasound-guided shoulder pain injection therapy integrates diagnosis and treatment, with obvious therapeutic effects, and the drug can reach the lesion directly, avoiding damage to nerves and blood vessels, with little side effects. It is worth to promote the application in clinical practice.