Objectives To evaluate the efficacy and safety of ultrasound-guided percutaneous thermal ablation for abdominal wall metastases. Materials & methods We retrospectively analyzed patients with abdominal wall metastatic nodules who underwent ultrasound-guided microwave ablation (MWA) from August 2018 to September 2024. Tumor volume (V), volume reduction rate (VRR), pain scores, and University of Washington Quality of Life (Uw-QOL) scores were measured at one, three, and six months postoperative. Results A total of twelve patients were included in the study (8 males and 4 females), with one male patient excluded due to incomplete follow-up data. The median patient age was 51.5 years (range: 37-75). All patients were successfully treated, with no local recurrence noted during follow-up. Tumor volume reduction rates were 45.4%, 76.9%, and 96% at one, three, and six months, respectively. By the end of the follow-up period, the average pain scores decreased significantly from 7.09 +/- 0.70 to 2.18 +/- 1.16 (p < 0.001). The quality of life of patients was significantly improved, and the Uw-Qol of score increased from 1148.63 +/- 94.07 to 1269.54 +/- 118.25 (p < 0.05). No patient appeared serious complications. The clinical symptoms and quality of life of all patients were significantly improved. Conclusion Ultrasound-guided percutaneous thermal ablation is a safe and effective minimally invasive method for the treatment of metastatic nodules of abdominal wall, presenting a viable option for patients who are unsuitable for or unwilling to undergo surgery.