A percutaneous infratemporal fossa-outer orbital wall endoscopic puncture guide plate, including 1 or 2 base plates, the base plate is composed of a base and a guide plate, the base is a curved plate that fits the curvature of the outer scalp of the temporalis muscle, and its front end and The hairline has the same curvature; the base is provided with an observation hole; the front of the base is provided with a guide plate, which is integrally formed with the base; the guide plate is provided with the first guide hole for placing the endoscope and 2 ultrasonic scalpels or The second guide hole of the suction device is located on both sides of the first guide hole respectively, and the first guide hole and the second guide hole are integrally formed with the base. The invention also discloses a usage method of the puncture guide plate. The puncture guide can shorten the operation time, has high compatibility with intraoperative surgical equipment and monitoring equipment, can reduce the probability of failure to locate the infratemporal fossa, and guide the outer wall of the orbit to open a window of about 3 cm2 to 4 cm2 to avoid excessive fenestration. Cerebrospinal fluid leaks, especially in patients with low dura mater in the anterior fossa.