HIFU is a noninvasive, acoustic therapeutic technique that utilizes high intensity acoustic field in the ultrasound focus to kill the targeted tissue for disease treatment purpose. The feasibility of monitoring and guiding HIFU treatment using the optical property change in the superficial area of biological tissue is explored. Ex-vivo bovine liver tissue was treated using different HIFU doses (same energy level for Os, 1s, 5s, 9s) in this research. The 3D structure volume and elastogram were acquired in the lesion area after HIFU treatment. The OCT structure images clearly show the boundary of HIFU lesion area and surrounding normal tissue, even for 1s treatment time, which agree well with the elastography results. The average OCT signal intensity and OCT signal attenuation ratio in the lesion area grows as the treatment time increases. Combined with OCT needle probe, the proposed method has a large potential not only to be used for superficial diseases treatment monitoring, but also to be used for high-precision-demanded diseases treatment monitoring, e.g. nervous disease treatment monitoring.