Injuries involving only the lungs are relatively rare; generally they are a combination of thoracic and pulmonary trauma. As a result of the increased incidence of severe polytraumata combined injuries have become more frequent. Isolated thoraco-pulmonary injuries by stabbing or a bullet are comparatively rare. Various types of lung injuries are described. During 1970-1976 388 persons with various injuries involving the chest were admitted to the Surgical Unit of the University Hospital, Düsseldorf. In 155 of them (40%) the lungs were injured; in only 49 was the trauma confined to the thorax and lungs. Over-all mortality was 60%. The case material was classified as (1) isolated lung injuries without damage to the thorax; (2) combined injuries to the chest wall and lungs. Combined injuries predominated in the proportion of 136:19 cases. Polytraumatised persons predominated in both groups (71 and 98% respectively). The clinical features and treatment of the various types of injuries are reviewed.