In the present study the aims were to analyse the difference in various treatment, complications and recurrence rates between patients with spontaneous pneumothorax and those associated with chronic obstructive lung disease (COLD). We made a retrospective analysis with regard to the therapy of all patients with spontaneous pneumothorax who were treated in the district lung hospital Lostau from 1. Jan 1986 to 31. Dec 1988 (171 patients, men: 136, women: 35). 45 patients suffered from a COLD (men: 42, women: 3). 3 methods of the treatment were set in: 1. conservative management by expectant observation, 2. the aspiration once or repeatedly with the pneumothorax apparatus and 3. the rubber-tube drainage. We consider the aspiration of spontaneous pneumothorax with pneumothorax apparatus as an effective method, which is not very burdensome for the patients. It is our opinion that the practice in patients with a COLD is more active than this in other patients, in form of the rubber-tube drainage.