The present work explores different conditions of thermosonication (TS) processing that would ensure microbiological and enzymatic safety for guava juice while simultaneously maximizing the preservation of its quality attributes. The guava juice was subjected to TS treatment (frequency: 40 kHz; power: 200 W; Temperature: 40, 60, and 80 °C; Time: 2, 6 and 10 min) and was compared with fresh and pasteurized (90 °C/60 s) juice samples. The objectives of the research work were to determine the effect of thermosonication on the quality attributes such as total soluble solids (TSS), pH, titratable acidity, cloud value, color attributes, total phenolic contents, total flavonoid contents, antioxidant activity, ascorbic acid levels, enzymatic, microbiological, and sensory properties. The thermosonicated and pasteurized samples showed no significant (p > 0.05) changes in pH, total soluble solids, and titratable acidity. TS improved the cloud value and color attributes. Furthermore, TS enhanced total phenols (10 to17%), flavonoids (5 to 25%), antioxidant activity (10.45% to 14.55%) and retention of ascorbic acid (61.98–83.32%) relative to control. Thermosonicated sample at 80 °C/10 min gives the maximum inactivation of Pectin methyl esterase (PME), Peroxidase (POD) and Polyphenol oxidase (PPO) enzymes. While both thermosonication and pasteurization drastically decreased the microbial count to undetectable levels, only TS exhibited modest improvement in sensory qualities. The results demonstrated that TS can enhance the overall safety, quality, and commercial viability of guava juice as a practical substitute to pasteurization.