Abstract: OBJECTIVE To observe the effect of thoracoscopic surgery on control of postoperative pulmonary infection and recurrence of spontaneous pneumothorax so as to provide guidance for clinical diagnosis and treatment. METHODS The clinical data were collected from 149 patients with spontaneous pneumothorax who were treated in the hospital from Jan 2013 to Jan 2015, the patients were divided into the observation group with 73 cases (thoracoscopic surgery) and the control group with 76 cases (thoracotomy) according to the surgery type. The incidence of postoperative pulmonary infection and distribution of pathogens were analyzed and compared between the two groups of patients, and the follow-up was conducted to observe the recurrence rate of pneumothorax 1 year after the surgery. RESULTS The incidence of postoperative pulmonary infection of the observation group was 2.7% (2/73), significantly lower than 11.8% (9/76) of the control group (χ²=4.512,P=0.034). The postoperative hospitalization duration and the time for out of bed were remarkably shorter in the observation group than in the control group, and the length of surgical incision of the observation group was significantly shorter than that of the control group (P<0.05). Among the pathogens isolated from 11 patients with pulmonary infection, the gram-negative bacteria accounted for 63.64% (7 strains), and the gram-positive bacteria accounted for 36.36% (4 strains). The levels of peripheral blood IL-6 and IL-8 of the observation group were lower than those of the control group, while the PCT level of the observation group was higher than that of the control group, and there was significant difference (P<0.05); the cumulative recurrence rate of pneumothorax of the observation group was 13.70% (10/73), significantly lower than 32.89% (25/76) of the control group, and there was significant difference (Log-rankχ²=7.994,P=0.005). CONCLUSION As compared with the thoracotomy, the thoracoscopic surgery can effectively reduce the incidence of postoperative pulmonary infection and recurrence of spontaneous pneumothorax.