A PZT transducer-horn integrated ultrasonic driving structure consists of a nut, a bolt, a left PZT circular stack, a flange, a right PZT truncated stack and a horn. The horn, the right PZT truncated stack, the flange and the left PZT circular stack are arranged in sequence and connected via the bolt and then fastened via the nut; the right PZT transducer is a truncated cone-shaped stack formed by PZT circular plates; and the right PZT transducer and the horn are integrated to form the ultrasonic driving structure. Considering the dimension of PZT on two sides of the flange and the horn meet the requirements for ultrasonic vibration node and antinode, the dimension of round contour of the circular PZT stack and flange is reduced to increase the thickness of the truncated PZT stack and flange. With the integrated structure, the effect of reducing the contour dimension of the ultrasonic driving surgical device can be obtained, and the outer diameter is reduced to the range of 8-10 mm as compared with the range of 12-15 mm in the prior art, thereby further meeting the application requirements.