The invention provides a positioning and guiding system for spine surgery. The positioning and guiding system comprises a human body information acquisition module, a spine position positioning module, a spine image acquisition module, a processor, a controller, a spine model drawing module, a display module and a data storage module, wherein the display module comprises a display; the human body information acquisition module is connected with the spine position positioning module, the spine position positioning module is connected with the spine image acquisition module, the spine image acquisition module is connected with the processor, the processor is connected with the controller, the controller is connected with the spine model drawing module, and the spine model drawing module is connected with the display module; and the display module is connected with the data storage module. The defect that existing spine images are not clear is overcome, spine model information is stored through the data storage module, a surgeon can conveniently check the spine disease position of a patient for the second time, the risk of a spine surgical operation is reduced, and the success rate of the operation is increased.