This study compares the process conditions, physicochemical properties, structural composition, and activity of polysaccharides isolated from leechie peel (LPP) using ultrasound-assisted extraction (UAE) with enzyme and alkali solution extraction (ASE). The results show that the total sugar content of LPP extracted by UAE was 75.65%, significantly higher than that extracted by ASE. The optimal conditions for UAE were: extraction temperature of 68.78°C, ultrasonic enzymolysis time of 39.68 minutes, pectinase dosage of 4.03%, solid-liquid ratio of 1:30 g/mL, and ultrasonic power of 360 W. UAE-LPP was an α-type polysaccharide containing 15.83% uronic acid and exhibited strong anti-lipid peroxidation and reducing activities. Ultrasound-assisted enzymatic extraction is an effective method to improve the content and activity of natural plant polysaccharides, offering advantages such as short time consumption, simple process, and ease of operation, which can enhance the utilization rate of polysaccharides and provide a scientific basis for the development and utilization of LPP.This study compares the process conditions, physicochemical properties, structural composition, and activity of polysaccharides isolated from leechie peel (LPP) using ultrasound-assisted extraction (UAE) with enzyme and alkali solution extraction (ASE). The results show that the total sugar content of LPP extracted by UAE was 75.65%, significantly higher than that extracted by ASE. The optimal conditions for UAE were: extraction temperature of 68.78°C, ultrasonic enzymolysis time of 39.68 minutes, pectinase dosage of 4.03%, solid-liquid ratio of 1:30 g/mL, and ultrasonic power of 360 W. UAE-LPP was an α-type polysaccharide containing 15.83% uronic acid and exhibited strong anti-lipid peroxidation and reducing activities. Ultrasound-assisted enzymatic extraction is an effective method to improve the content and activity of natural plant polysaccharides, offering advantages such as short time consumption, simple process, and ease of operation, which can enhance the utilization rate of polysaccharides and provide a scientific basis for the development and utilization of LPP.