Introduction: Peripheral pulmonary nodules are very common in clinical settings. Bronchoscopic transparenchymal nodule access (BTPNA) was useful in acquiring adequate tissue samples for the nodules which have not airway directly leading to them. However, in some patients, it was not possible to orientate the bronchoscope at the POE location to achieve a straight-line tunnel path to the target nodule due to limitations of the bronchoscope size and angulation. We have developed a novel procedure which allows sampling of SPNs via a BTPMNA procedure, in which we insert ultrathin bronchoscopy MP290F into POE, adjust the angle of MP290F under CBCT and obtain the biopsy samples through MP290F. Here, we report the BTPMNA results as a first in human case series. Methods: We retrospectively analyzed 9 patients with SPNs who underwent BTPMNA from March 2022 to Aug 2022 in Xi?an International Medical Center hospital. We collected the baseline information of participants, reported diagnostic yield and complications. Results: There were no adverse events during the procedures. Adequate biopsies were obtained from 9 patients (100%). Of the 9 lesions diagnosed by this procedure, 7 were lung cancers, 2 were tuberculosis. Conclusions: This first in human case series demonstrates that BTPMNA is safe and feasible.