Abstract: Objective To discuss the application of predictive nursing in ultrasound-guided puncture biopsy for patients with peripheral pulmonary disease and COPD. Methods A total of 84 patients with peripheral pulmonary disease and COPD were selected as the research objects from those admitted in Bozhou People's Hospital between March 2015 and November 2017. The patients were given ultrasound-guided puncture biopsy after signing the informed consent. Patients were randomly divided into the control group and the experimental group using random number table, with 42 cases in each group. The control group was given conventional nursing while the experimental group was given predictive nursing. The two groups were analyzed for the success rate of sampling, the success rate of puncture, the incidence of postoperative complication and nursing satisfaction. Results Both of the two groups were successfully completed biopsy. A total of 129 biopsies were performed in the experimental group, where 3 biopsies were unsatisfied, with the success rate of sampling as 97.67%; finally, 41 cases were correctly diagnosed, and 1 case was unclear, with the success rate of puncture as 97.62%. The success rate of sampling and the success rate of puncture were both 85.71%, which were significantly lower than those in the experimental group, with statistically significant difference (P<0.05). After puncture, 3 cases occurred mild complications in the experimental group (the incidence of complication=7.1%), and 8 cases occurred complications in the control group (the incidence of complication=19%). The incidence of complication was obviously higher in the control group than in the experimental group, with statistically significant difference (P<0.05). In terms of nursing satisfaction, the nursing score was 96.31±3.26 points in the experimental group, while 85.02±4.02 in the control group. The satisfaction of patients in the experimental group was significantly higher than that in the control group, and the difference between the two groups was statistically significant. However, there was no significant difference in pathological results between the two groups (P>0.05). Conclusion For patients with peripulmonary lesions combined with COPD, the application of predictive nursing in the ultrasound-guided puncture biopsy can effectively reduce complications and improve the success rate of puncture and nursing satisfaction.