The invention discloses a preparation method of triamcinolone acetonide. A compound I prednisone acetate which is taken as a starting material is subjected to a primary elimination reaction, an oxidation reaction, a condensation reaction, a reduction reaction, a secondary elimination reaction, a hydrolysis reaction, an epoxidation reaction and a fluorination reaction, so that an end-product IX, 9-fluoro-11beta, 21-dihydroxyl-16a,17-[(1-methyl ethylidene) bi(oxo)]-pregnen steroid-1,4-diene-3, 20-diketone, namely triamcinolone acetonide, is obtained. The preparation method of the triamcinolone acetonide has the advantages that a relatively cheap starting raw material is adopted, each reaction step can be relatively easily realized, and yield is relatively high, so that production is more economic and safer, and the triamcinolone acetonide is more applicable to industrial production; a multi-step protection and deprotection operation is simplified, a synthetic route is greatly shortened, and production cost is reduced; possibility that a three-position carbonyl group is reduced in a reduction process is almost zero, so that side effects are greatly reduced, and yield and quality of the reduction reaction are improved.