• CT-guided biopsy of lung nodules ≤8 mm has high diagnostic accuracy. • Safety profiles are similar between nodules ≤8 mm and 8-10 mm. • Nodules ≤6 mm have higher rates of non-diagnostic results in biopsy. • Non-subpleural nodules and old age are risk factors for higher grade haemorrhage. • Biopsy is feasible for diagnosing nodules >6 and ≤8 mm.