Objective To evaluate whether the hand-drawn bronchial map can increase the endobronchial ultrasonography (EBUS) detection rate and the diagnosis rate for peripheral lung lesions.Methods We retrospectively analyzed 105 patients and divided them into hand-drawn navigation-EBUS group (n = 71) and traditional navigation-EBUS group (n = 34) according to different navigation methods. Collect case data on age, gender, lesion imaging characteristics (density, location, presence or absence of bronchial inflation sign), biopsy frequency, and final diagnosis from two groups of patients, and analyze the EBUS arrival rate, diagnosis rate, and influencing factors.Results Compared to that in the traditional navigation-EBUS group, the EBUS detection rate in the hand-drawn navigation-EBUS group was significantly higher. When lesions were > 20 mm and ≤ 30 mm, the diagnosis rate in the hand-drawn navigation-EBUS group was significantly higher than that in the traditional navigation-EBUS group. Multivariate Logistic regression analysis showed that lesions > 20 mm (P = 0.042) and bronchial generation of lesions ≤ 5th generation (P = 0.005) were favorable factors affecting the diagnosis rate of hand-drawn navigation-EBUS.Conclusion A hand-drawn bronchial map greatly increases the EBUS detection rate and diagnostic yield of bronchoscopy for peripheral lung lesions.