Objective To investigate the clinical value of CT-guided percutaneous bone biopsy in skeletal lesions.Methods Totally 857 patients with skeletal lesions who underwent CT-guided percutaneous bone biopsy were analyzed retrospectively.The position and path of puncture were selected according to the adjacent and safety principle after CT localization.Lesions were penetrated with 8-13G bone puncture needles or 16-18G trigger-type biopsy needles for obtaining specimens.Results The whole procedures were generally finished within 20-40 min,and adequate samples were obtained for pathologic examinations in all patients.The pathological findings of biopsy for 766 patients were consistent with that of surgeries (89.38%) .No false positive patient was found.Postoperative complications occurred in 27 patients (3.15%) ,including local hematomas in 22 patients,nerve injury in 1 patient and infection in 4 patients.Conclusion CT-guided percutaneous bone biopsy is safe and with high diagnostic accuracy.It can be used to diagnose metastases,primary bone tumors,tumor-like lesions and inflammatory lesions.The reasonable selection of the path of puncture,puncture needles and biopsy methods can improve the success rate of biopsy.