Objective To investigate the influencing factors of complications in performing ultrasound-guided percutaneous biopsy of liver lesions. Methods All of 248 patients undergoing ultrasound-guided percutaneous liver biopsy were enrolled. The univariate and multivariate Logistic retrospective analysis were performed to study the influence of the patient-related factors (sex, age), lesion-related factors (lesion size, location, pathological type, with or without necrosis), and procedure-related factors (number of puncture) on the incidence of 第一作者：蒋骁，南京医科大学附属无锡人民医院超声科，214023 无锡 通讯作者：吴鹏西，南京医科大学附属无锡人民医院超声科，214023 无锡 Email：Wupengxiwxry@hotmail.com complications by ultrasound-guided. Results Puncture was all succeed in all 248 cases. The diagnostic accuracy rate of ultrasound-guided percutaneous biopsy was 94.8% (235/248); the complication rate was 11.3% (28/248), among which the frequency of pain was 6.9% (17/248), hemorrhage was 4.0% (10/248). The single factor analysis showed that the size of the lesion, number of puncture could influence the incidence of complications (P＜0.05). The multi-factor analysis showed that the umber of puncture was a risk factor (β=1.547), while the size of the lesion was a protective factor (β=-1.097). Conclusions The umber of puncture and the size of the lesion are independent factors that effect the incidence of complications in performing ultrasound-guided percutaneous biopsy of liver lesions. The umber of puncture is a risk factor, while the size if the lesion is a protective factor.