The invention discloses a machine tool fine adjustment sizing block, and relates to the technical field of a device for installing a machine tool or regulating the machine tool height. The machine tool fine adjustment sizing block comprises a concave base, a positioning post, a first tapered wedge block, a second tapered wedge block, a first support block, a second support block and a fine adjustment screw bolt. The fine adjustment screw bolt clockwise or anticlockwise rotates, and the first tapered wedge block and the second tapered wedge block are positioned on the fine adjustment screw bolt in different threaded directions, so the moving directions of the first tapered wedge block and the second tapered wedge block are opposite, meanwhile, the first tapered wedge block and the second tapered wedge block move towards two sides or the middle, meanwhile, the first support block and the second support block are driven to descend or ascend, the vertical fine adjustment function is realized, the horizontal translation is avoided, the position precision of an adjusted element in the horizontal direction is ensured, and the fine adjustment effect is good.