This paper reported a case of anesthesia management of cesarean section while the puerpera has scoliosis and limb nerve injury. In this case, the puerpera was born with obvious scoliosis in the thoracic segment of the spine, limited movement of the left upper limb and limited walking gait. Combined with the medical history, the left ipsilateral upper and lower limb nerve injury was suspected to be caused by cerebral palsy. However, due to the limited economic conditions of the patients, the puerpera and their families refused to carry out further examination to determine the causes of the limited physical activity. Thus Intraspinal anesthesia may cause further aggravation of nerve injury. In addition, patients with thoracic scoliosis may have ventilation problems, and perioperative pulmonary complications increase. General anesthesia is not applicable for this case of high risk. Considering the appeal factors, the anesthesiologist decided to choose local nerve block guided by ultrasound. Bilateral transverse ventral nerve block and bilateral iliac inferior ventral and ilioinguinal nerves were selected. Intravenous analgesics and sedatives were added immediately after delivery. The procedure of surgery was smooth and the anesthesia degree was appropriate. No obvious adverse reactions and complications were observed. The ultrason-guided nerve block adopted in this case provides a new anesthesia scheme for the puerpera with difficulty in spinal anesthesia while avoiding the risk to puerpera and fetus caused by cesarean section under general anesthesia at the same time. Our case report provide a new choice and strong evidence for the clinical decision of obstetric anesthesia.