Objective In this article we report our methods and effects of CT-guided bone biopsy in extremities.Methods 50 patients with extremital bone lesion were candidates for CT-guided biopsy.Two or more procedures were routinely performed in each case.Ackmann drill was used for 13 patients with sclerotic lesions.Temno core needle was used for 42 cases.Fine needle aspiration was combined for 12 patients with cystic or obviously liquefied lesions.Results In the 50 cases,a diagnosis was possible in 88%(44/50).The six unsatisfactory results were from sclerotic lesions(n=3),liquefied lesions(n=2) and mixed lesion(n=1).50cases were divided into primary malignant tumors(n=23),primary benign tumors and tumor-like lesions(n=12),metastatic tumors(n=8),and bone inflammations (n=7).Their diagnostic accuracies of CT-guided biopsy were 91%,83%,100% and 71% separately.No severe complications were observed in our series.Conclusion CT-guided extremital bone biopsy is a safe,accurate and effective method.Bone drill,needle core and fine needle aspiration should be slected according to the type of bone lesions.In order to increasing its accuracy,the operator should avoid necrotic areas and select more then one point to get samples.One modality can be performed concomitantly with other one in the evaluation of bone lesions,since the three modalities are complementary.