Objective To explore the benefit and safety evaluation of peripherally inserted central catheters（PICC） insertion guided by digital subtraction angiography（DSA）. Methods A total of 185 patients were divided randomly into a control group of 80 patients and a DSA group of 105 patients. The control group received PICC insertion in the PICC center, then were escorted to the department of radiation medicine for X-ray imaging, and evaluated by vascular surgical doctors if needed. The DSA group received PICC insertion and catheter adjustment in the interventional radiology room under the DSA equipment, without being exposed to X-ray imaging; with the help of the Cardiac mode, catheter tip was located, and interventional therapists intervened whenever ne-cessary.Under this method, patients needed to make an appointment and received PICC insertion in an array. The insertion success rate, the time to insertion completion, the rate of successful PICC tip placement, and dose area product (DAP) of radiation were compared between the 2 groups. Results The time to insertion completion in the DSA group was significantly shorter, and the rates of successful PICC tip placement and insertion were significantly higher, than in the controls （P＜0.05,P＜0.01）. Conclusion Rational utilization of DSA in PICC insertion can improve insertion efficiency, while not increasing X-ray exposure in nurses and patients.