OBJECTIVE: To compare the relative safety and efficacy of the Chiba needle and the Trocar needle in CT-guided microcoil localization of pulmonary nodules. METHODS: A retrospective study was conducted on 118 patients who underwent CT-guided microcoil localization and subsequent video-assisted thoracoscopic surgery (VATS) resection from September to November 2023. Patients were divided into the Chiba needle group (n = 75) and the Trocar needle group (n = 43). Characteristics of patients, lesions, procedures, and surgeries were statistically analyzed. Univariate and multivariate logistic regression analyses were used to determine potential risk factors for technical failure and complications. RESULTS: The success rate of localization was 97.3 % for the Chiba needle group and 100 % for the Trocar needle group, with no significant difference (p = 0.533). Complications included pneumothorax in 16 % of the Chiba group and 18.6 % of the Trocar group (p = 0.914), and parenchymal hemorrhage in 25.3 % and 41.9 % respectively (p = 0.098). There were no significant differences in puncture depth, procedure duration, or interval between procedure and surgery. Multivariate logistic regression analyses identified longer puncture depth as a risk factor both for pneumothorax (p = 0.027) and parenchymal hemorrhage (p = 0.006), while the Trocar needle was identified as a risk factor for parenchymal hemorrhage (p = 0.035). CONCLUSION: This study found no significant difference in the effectiveness of Chiba and Trocar needles for preoperative CT-guided lung nodule localization. Both needles showed high success rates and comparable pneumothorax profiles. However, the Trocar needle was found associated with a higher incidence of parenchymal hemorrhage.