Abstract: Objective To study the application of ultrasound-guided biopsy in diagnosis of musculoskeletal system diseases and summarize their imaging features. Methods Thirty-two patients with musculoskeletal system diseases who underwent ultrasoundguided biopsy and ultrasonograpgy in our department from June 2010 to June 2012 were included in this study. Results Of the 32 patients who underwent ultrasound-guided biopsy, 28 were diagnosed with musculoskeletal system diseases by histopathology with a qualitative diagnostic rate of 87.5% (28/32).Of these 28 patients, 26 were followed up, during which they were finally diagnosed with musculoskeletal system diseases by pathology with a qualitative diagnostic rate of 92.9% (26/28).Inflammation, metastatic tumor, and benign and malignant foci showed their characteristic ultrasound and imaging features. Conclusion Ultrasound-guided biopsy is highly accurate in diagnosis of musculoskeletal system diseases with few complications, and can be used in clinical diagnosis of musculoskeletal system diseases and in their differential diagnosis.