Lung puncture and bronchoscopy are not better, both can be used for the diagnosis and treatment of lung diseases. Clinically, lung puncture has a longer history of application than bronchoscopy, which is a newer type of examination that has only been used in the last 10 years or so. Both are commonly used in respiratory medicine and thoracic surgery, and can be used for the diagnosis of lung diseases. Usually, bronchoscopy is mainly used for brushing, needle aspiration biopsy, and exfoliative cytology, which is of great clinical significance for evaluating the condition of the bronchial tubes as well as detecting centralized lung cancer. Lung puncture has been used in the clinic in the early days, and its biopsy has a higher resolution with less interference. Nowadays, it is mainly used as a complementary examination tool to bronchoscopy, and lung biopsy is mainly used in cases of airway obstruction, sputum embolism, or peripheral lung space occupation, because bronchoscopy is not able to reach the lungs normally. The choice of lung puncture and bronchoscopy needs to be based on the physician’s precise analysis of the patient’s specific disease and active cooperation with the physician’s treatment.