Abstract: OBJECTIVE To explore the clinical value of CT in differential diagnosis of pulmonary fungal infections so as to provide guidance for clinical diagnosis. METHODS A total of 86 patients with pulmonary fungal infections who were treated in the hospital from Jan 2015 to Dec 2015 were enrolled in the study and received X-ray examination and CT scan, then the morphological imaging features of the lung lesions were observed, meanwhile, 40 patients with lung cancer, tuberculosis were chosen as the control group, and the imaging data were compared among all of the patients. RESULTS The positive rate of the pulmonary fungal infections was 73.3% by the CT examination, significantly higher than 10.5% by the X-ray examination(P<0.05). The etiological examination showed that the Aspergillus, Cryptococcus, Candida albicans, Histoplasma, and Mucor were dominant among the pathogens causing the pulmonary fungal infection, accounting for 40.70%, 31.40%, 17.44%, 8.14%, and 2.33%, respectively. Of the 86 patients with pulmonary fungal infections, 32 had mass lesions, 38 had patch, nodules lesions, and 16 had solid lesions. As compared with the lung cancer group, the performance frequency of deep lobulated, air bronchogram, long burr, and dizzy of the fungal infection group was remarkably increased; the number of the patients with indentation, vacuole sign, or mediastinal lymph node enlargement was significantly reduced. As compared with the tuberculosis group, the performance frequency of shallow lobes deep lobulated, air bronchogram, long burr, short burr, and dizzy of the fungal infection group was remarkably increased; the number of the patients with satellite lesions, calcification, and lymph node enlargement was significantly reduced (P<0.05). CONCLUSION The CT manifestations of the patients with pulmonary fungal infections are diverse, some of which can be used for differential diagnosis of other diseases and have high reference value in the clinical diagnosis.