Bone marrow aspiration is an essential tool for the diagnosis of most leukemias, but many patients and their families have doubts about bone marrow aspiration, mainly because of the risks associated with this procedure. Bone marrow puncture is often performed on the posterior superior iliac spine or anterior superior iliac spine of the pelvis because the bony landmarks are clearer and there are no large blood vessels or nerve trunks around this area, which is safe. If multiple punctures are unsatisfactory, sternal puncture may be chosen in a few cases, which is also safe as long as the needle is inserted obliquely and does not penetrate the sternum. There are few contraindications for bone marrow puncture, except for severe hemophilia and some diseases with coagulation factor deficiency, which can be performed, and should avoid inflammatory or deformed puncture sites.