To summarize the nursing experience of successfully placing a peripherally inserted central catheter （PICC） via the thoracoepigastric vein in an extremely low birth weight infant with difficult catheterization. The following nursing measures were adopted to address issues such as prematurity，prolonged illness，poor vascular conditions，and severe catheterization difficulties. We conducted a thorough risk assessment before catheterization and selected the thoracoepigastric vein as the PICC insertion site，overcame the impact of chest movements during catheterization by choosing appropriate puncture techniques and timing to ensure puncture success，used methods such as gentle soothing and warming the disinfectant to prevent vascular contraction，and assisted with bedside ultrasound guidance，actively monitored for PICC-related complications after catheterization. Ultimately，the PICC was successfully placed via the thoracoepigastric vein，ensuring timely completion of treatments. The catheter functioned well for 19 days without any complications. During a 2-year outpatient follow-up after discharge，the infant was in good condition.