Objective To investigate the effect of sugammadex for reversal of neuromuscular blockade postoperatively in the patients with CT guided radiofrequency ablation of hepatic carcinoma under general anesthesia. Methods The clinical data of 220 patients with radiofrequency ablation of hepatic carcinoma under general anesthesia from November 2019 to February 2022 in our hospital were retrospectively analyzed. Patients were divided into sugammadex group (group S) with 108 patients and neostigmine group (group N) with 112 patients based on choice of neuromuscular blockade reversal. All was by intravenous anesthesia in two groups with same anesthesia induction and maintenance. Group S received intravenous sugammadex 2 mg/kg at the end of the surgery and group N neostigmine 2 mg combined with atropine 0.5-1.0 mg. Time to spontaneous breathing, time of tracheal extubation, period of postanesthesia care unit(PACU) stay and postoperative hospital stay between 2 groups were compared combined with rate of atelectasis examined by CT scan within 10 min after extubation, liver function 24 h postoperatively and pulmonary complication. Results The time to spontaneous breathing, time of extubation, and period of PACU stay in group S decreased significantly compared with those in group N (P<0.05). Both rate of atelectasis [35 (32.4%) vs. 59 (52.7%)]within 10 min after extubation and rate of pulmonary complication [4 (3.7%) vs. 11 (9.8%)] postoperatively decreased (all P<0.05). The liver function 24 h postoperatively in both groups was significantly higher than those before operation (P<0.05) without significant difference between two groups (P>0.05). Conclusions Sugammadex could reverse neuromuscular blockade more quickly and lowering the rates of early postoperative atelectasis and pulmonary complication of the patients with hepatic radiofrequency ablation.