Abstract: Objective To investigate the application value of CT-guided percutaneous needle biopsy with coaxial localization needle in deep lung lesions. Methods A total of 60 patients with deep pulmonary lesions undergoing percutaneous puncture biopsy with coaxial localization needle were selected and divided into two groups according to application of CT-guided coaxial localization needle. The observation group(n=33)underwent CT-guided percutaneous needle biopsy with coaxial localization needle, while the control group(n=27)underwent CT-guided percutaneous needle biopsy with conventional localization needle. The puncture time, the average puncture times, the success rate of one-time sampling, the detection rate of pathological changes, the accuracy rate of diagnosis and the incidence rate of complications were observed and compared between the two groups. Results The puncture time of the observation group was significantly shorter than that of the control group, the success rate of one-time sampling was significantly higher than that of the control group, and the failure rate of puncture was significantly lower than that of the control group(P<0.05). There was no significant difference in diagnostic accuracy of deep lung lesions between the two groups(P>0.05). In the observation group, the detection result was highly consistent with the results of operation and follow-up(Kappa=0.725), and had medium consistent results in the control group(Kappa=0.631). The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05). Conclusion CT-guided percutaneous needle biopsy with coaxial localization needle can increase the success rate of puncture and reduce the risk of puncture-related complications, which is highly - consistent with the results of surgery or follow-up.