The classification and diagnosis of bone and soft tissue tumors are extremely complicated, and it is difficult to make a correct diagnosis by clinical examination and imaging alone. Biopsy is a necessary way to diagnose most bone and soft tissue tumors. Biopsy is divided into puncture biopsy and excisional biopsy. Puncture biopsy is to take out about 0.3*0.3*1cm tissue by using coarse trocar needle and send it to pathology for diagnosis. Coarse trocar needle puncture is best performed in hospitals with a large number of bone and soft tissue tumor cases, where experienced physicians can get the tumor tissue, and the design of the puncture needle tract should be consistent with the surgical access in order to remove it during surgery, so the main surgeon is advocated to design the puncture needle tract abroad. The diagnosis of puncture pathology is very difficult, the sample size is small, and the diagnosis relies on specialists with extensive experience in bone and soft tissue tumor pathology. The diagnosis of difficult pathology often requires discussion among bone and soft tissue tumor specialists, pathologists and radiologists to confirm the diagnosis. In our bone and soft tissue tumor department, the correct diagnosis rate of puncture biopsy is over 90%, and we have accumulated rich clinical experience. It is often applied to the diagnosis of benign tumors, such as ossifying fibroma, aneurysmal bone cyst, osteoblastoma, giant cell tumor of bone, lipoma, nerve sheath tumor, etc., and malignant tumors: such as osteosarcoma, metastasis, malignant fibrous histiocytosis, fibrosarcoma, synovial sarcoma, smooth muscle sarcoma, etc. The operation takes less than 20 minutes, the surgical incision is about 0.3cm, and can be performed under local anesthesia, which also has the advantages of low cost, little trauma, and quick recovery. Incisional biopsy is often performed after a failed puncture biopsy, with an incision of about 6-8 cm, which is more traumatic and slower to recover, but more pathological tissues are taken, which helps the pathologist to make a comprehensive diagnosis. Incisional biopsy also has many technical details, such as incision design must be removed in the second surgery, intraoperative tumor-free operation, and proper postoperative drainage to prevent the occurrence of hematoma. It is very unfortunate that some primary hospitals carry out incisional biopsy, which makes it difficult to perform limb-preserving surgery for secondary extensive tumor resection and deprives patients of the opportunity to preserve their limbs.