The invention provides a throat swab acquisition method based on image identification and positioning. The method comprises the following steps: S1, shooting at an acquisition far end to obtain a far end acquisition image, identifying a circular contour of a mouthpiece in the far end acquisition image, and obtaining pixel coordinates of a circle center of the mouthpiece; S2, correcting a position of a throat swab acquisition mechanism, enabling the circle center pixel coordinates of the mouthpiece to coincide with pre-calibrated circle center pixel standard coordinates of the mouthpiece, and carrying out coarse positioning; S3, shooting at an acquisition near end to obtain a near-end acquisition image, and identifying uvula center pixel coordinates in the near-end acquisition image; and S4, calculating pixel coordinates of a replacement point of the acquisition area according to the uvula center pixel coordinates, and correcting the position of the throat swab acquisition mechanism, enabling pre-calibrated light spot circle center pixel coordinates to coincide with the pixel coordinates of the replacement point, and carrying out accurate positioning. The identification and positioning precision of the acquisition area is improved through two-step positioning, and the throat swab acquisition mechanism can be accurately guided to move to the position of the acquisition area.