The invention discloses a drug pressing machine for preparing small-diameter granular implants from powdery raw materials, including a machine frame, a mold frame, a hydraulic system, a forming mold, a vacuum drug collecting device, a control system and the like. The molding die is composed of a die, a punching pin, a punching pin fixing plate, and a guiding device. The vacuum drug collection device includes components such as a vacuum pump, a vacuum channel, and a drug collection box, which can realize the automatic collection of preparation particles. The control system is composed of programmable controller, photoelectric sensor, force sensor and instrument, etc., which can precisely control the pressure, mold movement direction and speed, time and position. The medicine pressing machine uses the powdery mixture as the raw material, presses it into granular implants with a diameter of 0.5-2mm, and puts them into the medicine collection box through vacuum suction, and the whole process is automatically completed. This medicine pressing machine can adjust various process parameters, mold hole number and hole diameter according to needs, and press dozens to hundreds of granular implants at a time. The extruded particles have high hardness, stable shape and smooth appearance.