Abstract: OBJECTIVE To explore the clinical efficacy of fiberoptic bronchoscopy and bronchoalveolar lavage in treatment of elderly patients with severe pulmonary infections so as to provide guidance for clinical treatment of the disease. METHODS A total of 86 elderly patients with severe pulmonary infections who were treated from Jan 2011 to Jan 2015 were enrolled in the study and randomly divided into the observation group and the control group, with 43 cases in each. The control group was given the conventional treatment, while the observation group was treated with additional fiberoptic bronchoscopy and bronchoalveolar lavage based on the conventional treatment. The therapeutic effect, time of recovery of clinical signs, and incidence of adverse reactions were observed and recorded, and the statistical analysis of data was performed with the use of SPSS 19.0 software. RESULTS The time of disappearance of cough, time of disappearance of expectoration, time of disappearance of pulmonary rales, and length of hospital stay were significantly shorter in the observation group than in the control group (P<0.05). The total effective rate of treatment of the observation group was 90.70%, significantly higher than 65.12% of the control group (P<0.05). The partial pressure of arterial oxygen (PaO₂), partial pressure of arterial carbon dioxide (Paco₂), and saturation of peripheral blood oxygen(SpO₂) of the two groups of patients were significantly improved after the lavage (P<0.05); the improvement was more significant in the observation group than in the control group(P<0.05). CONCLUSION The fiberoptic bronchoscopy and bronchoalveolar lavage can remarkably improve the clinical effect on treatment of the elderly patients with severe pulmonary infections and shorten the length of hospital stay.