The detection of peripheral pulmonary lesions has increased gradually with the popularity of CT. Rapid and accurate diagnosis, and individualized treatment are two aspects we need to pay great attention to. These situations also raise higher request for the technique in diagnosis and treatment. At present, the commonly used transthoracic methods can increase the risk of complications such as pneumothorax and bleeding. The newly bronchoscopic approaches for diagnosis and treatment make less injury via natural lumen and have been applied widely in clinics. This review will introduce the worth expecting progress in bronchoscopic diagnosis and treatment for peripheral pulmonary lesions.