A retrospective study was performed on 73 patients who underwent percutaneous computed tomography-guided needle biopsy between April 1998 and March 2003. All cases were treated by orthopedic surgeons at Nagoya Memorial Hospital. Diagnostic accuracy was examined statistically by anatomical location and diagnosis. The diagnostic accuracy for all 73 patients was 88% (64/73); and excluding patients with infection, it was 92% (55/60). No statistically significant difference was found by anatomical site. The accuracy was statistically significantly lower for primary bone tumors (P<0.005) and infection (P<0.05). The culture detection rate was 23% (3/13). No serious complications were seen. This report suggests that, with the advances in imaging technology and biopsy needles, one no longer sees the differences in diagnostic accuracy by anatomical site that result from the use of different biopsy needles for tumors of different locations and properties. Accuracy is thus determined largely by the disease. Infection was tuberculous in 4 of the 13 infection patients, and diagnosis was possible in all of these cases from the tissue examination. Needle biopsy seems useful in the sense that it can distinguish between tuberculous lesions in cases of spinal infection. In patients with a primary bone tumor, application of needle biopsy should be subjected to further consideration.