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Pathological results is the gold standard for the diagnosis of lymphoma. Lymph node puncture is convenient with a minor wound surface, but it can only obtain a slight amount of target tissues. Puncture combined with contrast-enhanced ultrasound can obtain target tissues were accurately. Here, we reported a 74-year-old male case of superficial lymphoma complicated with necrosis. He was admitted to our hospital due to the left inguinal mass accompanied by left lower limb edema for over 20 d. Contrast-enhanced ultrasound of lymph nodes prompted the possibility of lymphoma complicated with necrosis. The diagnosis of lymphoma was pathologically confirmed by contrast-enhanced ultrasound-guided puncture biopsy. Contrast-enhanced ultrasound contributes to avoiding the puncture of the necrotic area and enhance the accuracy of puncture sampling.