Background: The cannulation of the internal jugular vein is done to access the central vein for hemodynamic monitoring and other purposes. A safe internal cannulation of the jugular vein is performed using anatomical landmarks on the surface of the skin or using the ultrasound-guided method. In this study, we compared the ultrasound-guided technique and the anatomical landmark method for the internal ion of the jugular vein catheter by anesthesia residents on adult patients in terms of the rates of their success rate and complications. Methods: In this study, 90 patients were divided into 2 equal groups. The anatomical landmark technique was used in the first group and ultrasound guidance in the second group to cannulate the internal jugular vein. In both methods, the number of attempts, the rate of failure, the rate of carotid rupture, and the rate of complications such as pneumothorax, hematoma, and arrhythmias were documented. Results: There was no statistically significant difference between the 2 groups vis-à-vis the number of the attempts to catheterize each patient (P=0.352). Cannulation failure was reported in only 1 patient in each group, and there was no significant difference between the 2 groups (P=0.062). The results demonstrated no significant difference between the groups (P=0.750) concerning the rate of complications of the internal jugular vein catheterization. Conclusions: Neither of the methods of ultrasound guidance and anatomical landmarks had a significant superiority in terms of the success rate and the complications of the ion of the internal jugular vein catheter. The reason for the absence of a significant difference between the 2 groups in the above parameters was the anesthesia residents’ insufficient personal skills in performing ultrasound. (Iranian heart Journal 2018; 19(3): 30-37)