Bone tumors and soft tissue tumors are diseases that seriously endanger human health and life, and the incidence rate has gradually increased in recent years. Primary malignant bone tumors are mostly seen in adolescents and middle-aged people, and the common ones are osteosarcoma, Ewing sarcoma, chondrosarcoma, malignant fibrous histiocytoma, chordoma and so on, and common soft tissue malignant tumors are synovial sarcoma, fibrosarcoma, liposarcoma, rhabdomyosarcoma and so on, and metastatic cancer of the bone is most common in the Bone metastatic cancer is mostly found in middle-aged and old people, and the common primary tumors are lung cancer, breast cancer, kidney cancer, prostate cancer and thyroid cancer. Early detection, correct diagnosis and timely treatment have an important influence on the prognosis. With the continuous updating of examination means and methods, the correct rate of diagnosis has been gradually improved, but there are still a large number of tumors that do not have typical imaging characteristics and are difficult to diagnose. The correct diagnosis of bone and soft tissue tumors requires the combination of clinical manifestations, imaging manifestations and pathology. Among them, pathologic diagnosis plays a key role in the choice of treatment plan. The method of obtaining preoperative pathological diagnosis is biopsy, i.e., a small amount of diseased tissue is obtained and sent to the Department of Pathology, and the pathological diagnosis is obtained through microscopic observation or immunohistochemistry. Biopsy is divided into closed biopsy, incisional biopsy and excisional biopsy, of which closed biopsy is divided into needle aspiration biopsy (FNAB) and trocar needle aspiration biopsy. Puncture biopsy is currently the main way for bone tumor specialists to obtain preoperative pathological diagnosis. The limb-sparing surgery for malignant bone tumors and soft tissue tumors has become a major trend, which requires a clear diagnosis before surgery, and limb-sparing surgery has stricter requirements for the biopsy sampling route and method. Incorrect biopsy often results in contamination of important local structures such as blood vessels and nerve bundles, making the tumor unable to be completely resected, which leads to the failure of limb-sparing treatment and necessitates amputation. Tumors located in the pelvis and spine also need to be clearly diagnosed before surgery, and the surgical method should be decided according to the nature of the tumor. Therefore, before puncture biopsy, the nature, stage and treatment of the tumor should be fully understood, and adequate preoperative planning should be carried out to ensure that the needle path is located in the surgical incision, so that it can be completely removed during complete surgery. Puncture biopsy should be performed by experienced bone tumor specialists, and preferably by the surgeon himself, in order to improve the accuracy of the puncture biopsy, reduce complications, and facilitate the complete removal of the tumor after confirmation of the diagnosis. Biopsy should follow the following important principles: 1. Before biopsy, it should be highly valued and carefully planned like the development of surgical program. Because it is the beginning of tumor treatment, it is the crucial first step, and incorrect biopsy will bring disastrous consequences to patients. 2. Strictly observe the principle of aseptic operation, skin preparation and hemostatic suture like routine surgery. 3. Ensure that the biopsy does not affect the development of future surgical programs, and that the contaminated area of the biopsy should be able to be completely excised. 4. Ensure that there are enough representative tissue specimens for the pathologist to make a diagnosis. If the pathologist is unable to make a clear diagnosis, detailed clinical and imaging information should be provided in time. 5. If the doctor or hospital does not have the conditions for diagnosis and treatment of bone and soft tissue tumors, the patient should be referred to the doctor or hospital that has the conditions for diagnosis and treatment of bone tumors to receive regular treatment before biopsy.