To assess the clinical efficacy of a new single-incision axillary vein puncture technique for implanting totally implantable venous access ports (TIVAPs). A retrospective review of patient data from January 2023 to June 2023 at The Affiliated Suzhou Hospital of Nanjing Medical University was conducted. The study included adult patients with solid malignancies scheduled for intravenous chemotherapy and TIVAPs implantation. Patients were categorized into single-incision group (Group S) and dual-incision group (Group D) based on different venous access approaches. Baseline information, primary tumors, immediate adverse events, indwelling time, and early and late adverse events were collected. A total of 338 patients were included in the analysis, with 117 in Group S. and 221 in Group D. Baseline characteristics were comparable between the groups. The technical success rate was 99.1% in Group S and 98.6% in Group D, demonstrating similarity. The mean operative time was 26 min in Group S, significantly shorter than the 36 min in Group D (p <
0.05). Group D experienced more occurrences of localised ecchymosis and painful. Overall, Group S exhibited superiority over Group D in terms of immediate adverse events (p <
0.05). Follow-up data revealed comparable adverse events rates between the two groups. In conclusion, the study indicates that the single-incision axillary vein puncture technique can be safely implemented by an experienced team with a low incidence of adverse events. This approach can serve as a valuable alternative for clinical TIVAPs placement.