Objective Through preliminary clinical use of stereotactically guided wire localization biopsy for nonpalpable breast lesions, we discussed the diagnostic accuracy of the technique and its value in early detection of breast carcinomas. Methods Stereotactically guided wire localization biopsy was performed on 26 lesions. The distance between the needle tip and disease center (D) was calculated and compared to that directly obtained from measurement of the localization between wire tip and center of the lesion. Localization was rated as excellent, good, and bad when D values were ≤2.5 mm, =2.6-4.9 mm, and ≥5.0 mm, respectively. Results Excellent, good, and bad localization results were achieved in 20, 5, and 1 procedures, respectively. These data correlated well with the direct measurements of the localization between wire tip and center of the lesion. Resection of 26 lesions on single operation was achieved and the median volume of the resected specimens was 10 5 cm 3. The breast carcinoma detection rate of 6/26 was achieved. Conclusion Our initial application of the technique showed that stereotactically guided wire localization biopsy for nonpalpable breast lesions was an effective tool for the localization and specification of breast lesions. It could avoid false negativity and help excise the entire lesion without excessive excision of the surrounding normal tissues. The technique was one of those that was worthy of more widely application for the preoperative diagnosis of nonpalpable breast lesions.