Background:　Frontal　ventriculostomy　(FV)　is　essential　in　neurosurgery;　however,　traditional　freehand　puncture　methods　have　low　accuracy,　and　ultrasound　guidance　is　time　consuming　and　expensive.　To　improve　freehand　puncture　accuracy,　this　study　introduced　a　biplanar　intersection　(BI)　method,　and　analyzed　the　frontal-horn　puncture　mechanism.　No　related　reports　exist　to　date.　Methods:　Three-dimensional　(3D)　computed　tomography　(CT)　reconstruction　was　performed　using　data　from　random　patients,　aged　≥18　years,　who　presented　with　enlarged　lateral　ventricles,　and　an　Evans　index　＞0.33,　and　had　no　signs　of　ventricular　compression,　deformation,　displacement,　or　a　history　of　craniectomy.　This　study　was　conducted　at　Fujian　Provincial　Hospital　between　May　2022　and　May　2023.　Using　the　principles　of　BI,　we　determined　the　location　coordinates,　and　conducted　a　variance　analysis.　We　simulated　the　puncture　using　the　BI　method　and　compared　it　with　traditional　methods.　Differences　between　groups　were　evaluated　using　chi-squared　tests　and　independent　samples　t-tests.　Results:　A　total　of　135　patients　(110　males,　25　females;　aged　18-78　years)　were　included　in　the　study.　The　lateral　projection　was　situated　13.3±1.5　mm　anteriorly　and　45.7±4.1　mm　superiorly　in　relation　to　the　intersection　of　the　anterior　margin　of　the　tragus　and　the　superior　margin　of　the　zygomatic　arch.　The　anterior　projection　was　located　13.8±2.4　mm　above　and　5.5±1.1　mm　lateral　to　the　glabella.　The　mean　puncture　depth　was　determined　to　be　56　mm　(48-64　mm).　In　a　sub-analysis　of　36　patients,　the　BI　method　exhibited　a　significantly　higher　optimal　puncture　rate　(36/36　versus　31/36,　χ2=5.373,　P=0.021＜0.05)　and　reduced　lateral　deviation　(2.69　versus　13.97　mm,　t=-20.61,　P＜0.05).　Conclusions:　The　BI　method,　which　is　founded　on　rigorous　mathematical　principles,　was　shown　through　simulations　to　have　enhanced　precision　in　puncture　efficiency.　However,　further　clinical　research　needs　to　be　conducted　to　ascertain　its　effectiveness.　©　2025　AME　Publishing　Company.　All　rights　reserved.