The ultrasonically induced cytotoxic effects of hematoporphyrin (Hp) on Hepatoma 22 (H22) cells in vitro and vivo were investigated. Tumor cells were suspended in saline and exposed to ultrasound at 1.43 MHz for up to 60 s in the presence and absence of Hp. The viability of cells was evaluated by trypan blue exclusion test. The ultra-structure changes of H22 cells induced by ultrasonic irradiation were evaluated by scanning electron microscope (SEM) and transmission electron microscope (TEM). Lipid peroxidation in cell was estimated by the thiobarbicturic acid (TBA) method. Our experiments indicated that the ultrasonic intensity of 2 W/cm2, the Hp concentration of 100 lg/ml and the ultrasound exposure time of 60 s were the best conditions for sonodynamic treatment in vitro. The tumor volume and weight after the combination of Hp with ultrasound were remarkably inhibited. SEM and TEM observation found the cell ultra-structure was significantly damaged, and lipid peroxidation level remarkably increased after sonodynamic treatment. This study suggested the ultra-structural changes may play a key role in cell destruction induced by sonodynamic treatment and the biological mechanism might be involved in mediating the killing effect on H22 cells in our experiment mode.