<p>Closed thoracic drainage can be performed using a steel-needle-guided chest tube to treat pleural effusion or pneumothorax in clinics. However, the puncture procedure during surgery is invisible, increasing the risk of surgical failure. Therefore, it is necessary to design a visualization system for closed thoracic drainage. Augmented reality (AR) technology can assist in visualizing the internal anatomical structure and determining the insertion point on the body surface. The structure of the currently used steel-needle-guided chest tube was modified by integrating it with an ultrafine diameter camera to provide real-time visualization of the puncture process. After simulation experiments, the overall registration error of the AR method was measured to be within (3.59±0.53) mm, indicating its potential for clinical application. The ultrafine diameter camera module and improved steel-needle-guided chest tube can timely reflect the position of the needle tip in the human body. A comparative experiment showed that video guidance could improve the safety of the puncture process compared to the traditional method. Finally, a qualitative evaluation of the usability of the system was conducted through a questionnaire. This system facilitates the visualization of closed thoracic drainage puncture procedure and provides an implementation scheme to enhance the accuracy and safety of the operative step, which is conducive to reducing the learning curve and improving the proficiency of the doctors.</p>