Due to its advantages of small trauma and fast recovery, minimally invasive puncture surgery has been widely used in clinical practice in recent years, mainly for tissue biopsy, local ablation and local anesthesia. At present, the surgical instruments used in puncture surgery are oblique pointed flexible needles, which can avoid important organs and tissues and cause less damage to patients than rigid needles. In the process of surgery, effective path planning algorithms can assist doctors to improve the safety and accuracy of surgery, and the error of existing intraoperative path planning algorithms is in the order of millimeters, which limits its application in clinical surgery, and solutions need to be explored. Therefore, the research progress of flexible needle path planning in puncture surgery is sorted out, the factors affecting path planning are analyzed, the path planning algorithm of puncture needle is introduced in detail, the key problems that need to be solved are pointed out, and finally the future development direction of path planning of flexible needle surgical puncture needle is discussed from different aspects such as optimal path selection, parameter feedback and intraoperative realtime path planning method.