The invention discloses a needle pulling device, a monitoring system and a method, and relates to the technical field of medical apparatuses and instruments. The main aim of the invention is that, byarrangement of a needle pressing assembly and a needle pulling assembly, at the end of infusion, the hand back infusion needle head position is pressed by the needle pressing assembly, the needle pulling assembly performs pulling the needle automatically, and intelligent needle pulling is realized at the end of infusion. According to the technical scheme of the invention, the needle pulling devicecomprises a processor, the needle pressing assembly and the needle pulling assembly; the needle pressing assembly comprises a first drive assembly and a head pressing assembly, the needle pulling assembly comprises a second drive assembly and a crawling assembly, the processor is respectively connected with the first drive assembly, the second drive assembly and the crawling assembly; the first drive assembly is used for driving the head pressing assembly down and up, and the head pressing assembly is used for pressing the infusion needle head position; the second drive assembly is used for driving the crawling assembly to move towards the preset inclination direction, and the crawling assembly is used for crawling the end of the infusion needle. The device is mainly used for automatic needle pulling of the infusion needle.