OBJECTIVE To summarize the clinical features, diagnosis and surgical experience of pulmonary cryptococcosis. METHODS Twenty-seven patients with pulmonary cryptococcosis were treated surgically. There were 22 males and 5 females. The mean age at operation was (47.5 +/- 7.9) years. Open thoracotomy was performed for 17 patients, thoracoscopic surgery or video-assisted mini-thoracotomy surgery was performed for 10 patients; lobectomy was performed for 16 patients, pulmonary wedge resection was done for 9 patients; thoracoscopic pulmonary biopsy was conducted in 2 patients. RESULTS Complete removal of lesion was obtained in 25 patients and pulmonary biopsy was obtained in 2 patients. The 26 patients were followed up for 2 to 5 years, and 25 of them were cured. There was no post-operative deaths and no complications in the 25 patients. The complication of meningitis and recurrence were found in only one case. CONCLUSIONS Pulmonary cryptococcosis shows no specific clinical features and X-ray manifestations. For localized pulmonary cryptococcosis, surgical resection may be an effective procedure for its diagnosis and treatment. Because of its minimal invasiveness and short length of hospital stay, thoracoscopic surgery may be superior to open thoracotomy.