Poloxamer hydrogel possesses thermosensitive sol-gel transition characteristics and is widely used as a drug-controlled-release carrier for topical or injectable formulations. In this study, the effect of loading of a drug, acetaminophen (ACE), on the physical and structural properties of poloxamer 407 (P407) micelles and hydrogels was investigated. Differential scanning calorimetry measurements revealed that ACE reduced the critical micelle temperature and enthalpy of micellization of P407 solutions. The P407 micellization was promoted by ACE incorporation. Rheometry showed that ACE increased the sol-gel transition temperature and reduced the gel strength of P407. In situ small-angle X-ray scattering (SAXS) using synchrotron radiation revealed that ACE altered the structure of P407 micelles and their packing in the P407 gels. As ACE concentration increased, the P407 micelle packing changed from a face-centered cubic phase to a body-centered cubic phase. Furthermore, ACE disordered the micelle packing structure and induced the formation of an amorphous phase. Structural analysis of the P407 micelle packing indicated that ACE reduced the aggregation number () of P407 micelles in the gels. The SAXS study for diluted P407 solutions revealed that ACE reduced the P407 micelle size and its uniformity. The structural changes in P407 micelles by ACE loading (e.g., the reduction of , size, and size uniformity) would alter the micelle packing structure. It was found that these structural changes of micelle packing, especially the formation of an amorphous phase, could destabilize the P407 gel. As a result, the physical properties of P407 gels, such as gelation temperature and gel strength, were changed. This relationship between the structure and physical property of drug-loaded P407 gels was well-explained by correlating the micelle and gel structures. The mechanistic understanding of the change in the physical properties of P407 gels by drug loading is essential for the effective development of poloxamer gel formulations.