【Abstract】 Objective To evaluate clinical application value of foothead direction puncture pathway (FHDPP) in thermal ablation treatment against hepatic tumor adjacent to diaphragm.Methods Abdominal CT images were reconstructed and three representative sagittal planes and one coronal plane were selected as standard planes, in which standard lesions model beneath diaphragm were established. Then FHDPP were applied to stimulate the puncture these lesions. Diaphragm height, puncture pathway length and distance were measured in each planes. Accessibility was adopted to evaluate the ideal site of puncture needle within the standard lesion. Results 134 patients were collected, with 86 cases included and 48 cases excluded. Diaphragm heights of sagittal plane 2 and 3 were＜2cm in most patients and only 1511% of lesion e and 813% of lesion f located in these two planes were eligible for measurement. The proportion of full access in standard lesion a, b, c, d and b’ were 5243%, 6097%, 3837%, 5294% and 6353%, respectively; the median puncture pathway length were 1039cm,1337cm（dorsal side，ventral side 1266cm）, 1315cm, 888cm and 1126cm; the median puncture pathway distance were 21cm, 209cm（dorsal side，214cm ventral side）, 206cm, 211cm and 2145cm. Conclusion FHDPP has relatively high proportion of full access and tolerance level for standard lesion a, b, d and b’, which indicates application value in further clinical practice. The full access rate of standard lesion c was not high. The possibility of using FHDPP in lesion e and f is low.