Skeletal muscle pathology examination is the bridge between clinical and basic muscle pathology, has important application value for the diagnosis of neuromuscular disease, and can play a great role in determining the cause of muscle disease. Take a patient I met recently as an example, he had recurrent symptoms of muscle weakness and panic for several years, and had been hospitalized five times in outside hospitals, spending a lot of money with no good results and no clear diagnosis; then he was introduced to our hospital, and at that time he could walk, but he had panic and weakness when he went up half a floor and needed to rest, and he was diagnosed with lipid deposition myopathy by muscle biopsy, and the treatment effect was very good, and the symptoms disappeared completely in only two months, and the treatment cost was also very low. The treatment was very effective and the symptoms disappeared completely in only two months, and the cost of treatment was very low. There are many muscle lesions, including lipodystrophy, that can only be diagnosed by muscle biopsy. The procedure is relatively simple and a piece of cake for the surgeon, but in practice it is not as easy as it should be. If the specimen is not taken and transported properly, it is often difficult to make a definitive diagnosis. Muscle pathology has high requirements for the selection of sampling sites, specimen processing, and specific staining techniques. It is necessary to take the specimen from a muscle that reflects the nature of the lesion and avoids the effects of various artifacts, and of course, avoiding large blood vessels and nerve travel areas. Usually, in patients with chronic disease, muscles with mild to moderate loss of muscle strength should be taken, avoiding muscles that have been severely atrophied; while in acute disease, where the lesion has not yet developed extensive damage, more severely involved muscles should be selected for biopsy. Sometimes a muscle MRI is needed to help understand the distribution of the lesion and to choose the most appropriate site for taking the biopsy. Any form of acupuncture may cause muscle changes that affect the pathologic diagnosis of muscle biopsy, and muscles that have undergone acupuncture EMG should not be subjected to muscle biopsy within 1 month. There are also acupuncture treatments that can affect the outcome determination. Specimens must be frozen quickly within a short period of time so that the activity of various enzymes in the specimen can be maintained and important enzyme histochemical staining can be performed. Traditional formalin-fixed, paraffin sections are not applicable to muscle specimens, but unfortunately many hospitals are not equipped to do frozen sections and series of stains, and patients are advised not to do muscle biopsies in places where only paraffin sections can be done. A special area of muscle pathology neuropathology must provide the reader with clinical information and appropriate histochemical staining, enzyme staining, immunohistochemical staining or electron microscopy according to the clinical presentation in order to provide diagnostic value.