The invention provides a punching device for a medical silicone rubber catheter. The punching device includes a base, the base is a cuboid. One side of the long edge of the base is provided with a vertical sliding way module, and one side of the short edge of the base is provided with a horizontal sliding way module; a pipe body positioning seat is arranged on the lower portion of a vertical drillbit of the vertical sliding way module, and a positioning needle is arranged on the upper portion of the pipe body positioning seat. According to the punching device for the medical silicone rubber catheter, by using an electric and pneumatic hybrid power, the special drill bit and a punching needle are acted correspondingly, two processes are combined to simultaneously complete operation of punching of single side holes and opposite perforating holes at one time, the productive efficiency is greatly improved, and the punching forming cycle of the medical silicone rubber catheter is greatly shortened.