In recent years, we have increasingly encountered patients with “small nodules in the lungs” as the main presentation. This is the result of the popularization of low-dose spiral CT, and also has a lot to do with people’s increasing awareness of medical checkups. Lung cancer has become the most life-threatening malignancy and the leading cause of death from malignant tumors, and its incidence and mortality rate are increasing year by year. Although some progress has been made in many aspects of lung cancer treatment, the long-term survival of lung cancer patients has not yet been significantly improved. The 5-year survival rate after complete resection of early-stage lung cancer can reach over 70%, but the 5-year survival rate for surgical treatment of mid-stage lung cancer is only about 20%. Therefore, early detection, early diagnosis and early treatment are still the most effective measures to improve the cure rate and reduce the mortality rate of lung cancer at this stage. However, when a large number of small nodules in the lung appear in front of us, it brings great trouble to both our doctors and patients – early detection is achieved, but what about early diagnosis? Due to the poor prognosis of lung cancer, patients may have a feeling that they can’t afford to delay, which is indeed the case. Therefore, patients may feel anxious after finding small nodules in the lungs and desperately hope for a clear diagnosis from doctors. Objectively speaking, most of all intrapulmonary nodules are still benign lesions of some kind, but because of the severely poor prognosis of lung cancer, we need to face it with a very positive attitude. For doctors, this is a difficult problem. The current common practice is to review the chest CT regularly, usually at 3-month intervals, while dynamically observing the changes of the lesion in combination with some anti-infection or anti-tuberculosis treatment according to the doctor’s experience. However, this is the most unbearable for the patient, because as long as the diagnosis is not confirmed, the patient has no peace of mind, and, if it is lung cancer, it may be delayed. Any kind of examination has its precision. With chest CT, tiny nodules in the lungs as small as 5mm can be detected, although this requires the reader to have enough level and patience to separate the tiny nodules from the vascular shadow areas in the lungs. When intrapulmonary nodules are as small as 1-2 cm, all previously summarized features about the lung or nodal masses lose their significance… what could it be? Everyone is guessing. If you want to make a definitive diagnosis as soon as possible, you can only consider some invasive modalities, such as percutaneous lung aspiration biopsy. Obtaining tissue cells for pathological diagnosis is the gold standard of diagnosis. Although there is some risk of trauma, the author recommends that the majority of patients consider this diagnostic modality because these risks are predictable and manageable. Especially in the hands of those experienced surgeons, the risk of complications of hemorrhage and pneumothorax and its mild. In fact, the biggest difficulty with percutaneous lung puncture biopsy is that it is not done correctly. In order to reduce all risks, lung puncture is a “one hit wonder”, and one less needle can reduce all risks a little. The smaller the nodule is, the farther it is from the chest wall, the more inaccurate it is, and with breathing, the lung is always moving, so without the certainty of hitting it, blindly striking it will only increase the risk of various traumas. More importantly, if the penetration is not allowed, is the biopsies taken from the nodes? Can the results of pathological diagnosis be trusted? Rather than this, it is better not to wear it. This has greatly limited its popularity and a large number of hospitals do not perform this procedure as a result. Only with some precise positioning devices and mastering a few technical points, can we achieve every hit. In this regard, the author has deep experience. After the hospital was equipped with this positioning device, the diameter of the nodule that can be penetrated is now reduced from 2 cm to 1 cm. Many patients directly benefit, malignant, timely surgery did not delay treatment, benign, go to the psychological burden, happy life. In fact, some advances in medicine are always the result of multidisciplinary technological advances, for example, the emergence of low-dose spiral CT has led to a qualitative leap in the screening of early lung cancer. To deal with small intrapulmonary nodules, to borrow an old saying, we have to pay attention to it tactically, to make a clear diagnosis as early as possible and enter the treatment process, and at the same time, to defy it strategically, because we have enough means to make a clear diagnosis.