Objective To explore the application effect of CT guided puncture and drainage of pericardial effusion and related nursing coordination measures. Methods 50 cases of patients with pericardial effusion who were treated in our hospital from June 2013 to June 2015 were selected as the research objects. All patients underwent CT guided puncture and drainage. The success rate of once puncture and incidence of complications were statistically analyzed. The heart rate, blood pressure and other indexes were compared before and after puncture. Results The average time of CT guided puncture and drainage of pericardial effusion was (16.5±1.0) min, and average time of cathetering was (5.5+1.0)d. The success rate of once puncture was 100% and incidence of postoperative complications was 4%. There was 1 cases with subcutaneous hemorrhage and 1 case with puncture exudate. The uhrasonography showed that cardiac tamponade symptoms in patients were significantly relieved. After puncture, the heart rate (HR) (86.6±9.5) times/min was significantly lower than that before puncture [(91.8±12.4) times/min] (P<0.05). There was no significant difference in blood pressure and blood oxygen saturation (SpO2) before and after puncture (P>0.05). Conclusion CT guided puncture and drainage of pericardial effusion has the characteristics of high success rate of once puncture and fewer complications. Active and effective nursing care in perioperative period can be applied to reduce the occurrence of complications such as puncture exudate.