[Objective] To investigate the accuracy of preoperative puncture biopsy in the diagnosis of bone and soft tissue tumors and its related influence factors. [Methods] A total number of 111 patients with bone and soft tissue tumors were collected, who were diagnosed by preoperative puncture biopsy and underwent operations in our hospital from January to November in 2018. And the consistency between the results of biopsy and postoperative pathology was retrospectively analyzed to evaluate the accuracy of biopsy on diagnose. At the same time, the reasons for the negative results in this study were analyzed to explore the requirements of puncture biopsy for bone and soft tissue tumors, factors and tips that affects the accuracy of puncture biopsy, combining with reviewing literatures. [Results] According to the preoperative puncture and postoperative pathological results, the correlations were divided into three types: correct, supportive and negative. There were 111 patients, including 55 males and 56 females, aged 3-84 years, with an average age of 34 years. Puncture pathology was correct in 93 cases (83.8%), supported in 14 cases (12.6%), and negative in 4 cases (3.6%). [Conclusion] Preoperative biopsy achieves high accuracy and can be used as the primary way to diagnose bone and soft tissue tumors before further treatment.