Despite recent advances in endoscopic surgical techniques, small nonpalpable peripheral pulmonary nodules may not be amenable to thoracoscopic resection. To facilitate resection in such cases, a technique of percutaneous needle localization involving use of a conventional mammographic needle localization system and computed tomographic guidance was developed. The technique has been used successfully in localization of 19 peripheral pulmonary nodules in 20 patients referred for thoracoscopic surgery.