Intravascular ultrasound has been used in the treatment of chronic total occlusion (CTO) lesions with unknown entrance, but repeated alteration between microcatheter and ultrasound catheter may increase operation-associated complications. Independently developed by the Bethune International Peace Hospital, a new intravascular ultrasound dual-lumen microcatheter consists of an intravascular ultrasound catheter and a parallel therapeutic microcatheter. The ultrasound catheter and working wire are inserted synchronously into the lesion, enabling operation at the precise location with the real-time exploration of intravascular ultrasound. The modified device provides the interventionist with a new tool for the chronic occlusive lesions with enhanced precision in puncture. Hereby, we present one case of CTO lesions treated successfully using this new intravascular ultrasound double-lumen microcatheter, helping the readers to have a more intuitive understanding of the new technology.