To compare the sonographic characteristics of superficial basal cell carcinoma (sBCC) and non-superficial basal cell carcinomas (nsBCC).The ultrasound characteristics of 73 basal cell carcinoma (BCC) confirmed by surgical pathology were retrospectively analyzed, and the cases were divided into 11 cases of sBCC and 62 cases of nsBCC according to pathological subtypes. Ultrasound characteristics between groups were compared.Among all the ultrasound characteristics, lesion thickness (P = .000), shape (χ2  = 39.293, P = .000), basal changes (χ2  = 8.473, P = .037), infiltration level (χ2  = 46.140, P = .000), and distribution of intralesional hyperechogenic spots (χ2  = 15.699, P = .000) of the lesions had statistically significant correlation with pathological diagnosis of sBCC. While no significant differences were shown in surface morphology, keratinization, maximum diameter, intralesional echogenicity, posterior echogenic changes, and intralesional color Doppler flow of the lesions.Small lesion thickness, oblate shape, superficial dermal local infiltration, and <3 internal hyperechogenic spots distribution of BCC determined by high frequency ultrasound may positively correlate with pathological diagnosis of sBCC. This is beneficial for treatment planning.© 2023 American Institute of Ultrasound in Medicine.