Objective To discuss the clinical value of CT-guided percutaneous pulmonary biopsy. Methods We retrospectively analysed 429 patients who underwent CT-guided percutaneous pulmonary biopsy of Affiliated Hospital of Chengde Medical University from January 2015 to December 2019, and analyzed the puncture accuracy, incidence of major complications and influencing factors. Results All 429 patients completed lung biopsy successfully, 344 patients were diagnosed as malignant lesions, 84 patients were diagnosed as benign lesions, 2 patients had no definite diagnosis, the accuracy rate is 98.3%. The main complications were pneumothorax and pulmonary hemorrhage, with pneumothorax in 86 cases(20.0%), hemoptysis in 77 cases(17.9%) and pericardial effusion in 1 case(0.23%). Pneumothorax complications were related to the depth of injection, and the incidence of pneumothorax was higher when the needle depth was more than 5cm. Conclusion CT-guided percutaneous pulmonary biopsy is helpful for the diagnosis of lung space-occupying lesions with high accuracy, and it is one of the important methods for the definite diagnosis of lung lesions.