Abstract： AIM:To facilitate further understanding of necrotizing sarcoid granulomatosis. METHODS:Through review and analysis of the clinical documents of 3 NSG patients, the present study discusses the clinical manifestations, radiological and pathological diagnosis, treatment and prognosis of the 3 cases. RESULTS:The etiology of this rare disease remains unknown. Symptoms are most frequently fever, chest pain and productive cough etc. The radiological manifestations include solitary nodule,multiple nodules or masses in all three patients. The pathologic findings of NSG revealed confluent noncaseating sarcoid-like granulomas, granulomatous vasculitis and necrosis. Treatment with steroids appears to hasten recovery but relapses are frequent. The prognosis seems to correlate with the severity level of granulomatous vasculitis and scope of necrosis. CONCLUSION:Necrotizing sarcoid granulomatosis is rare and there are no specific definitive clinical manifestations therefore it is often misdiagnosed as other pulmonary diseases. Steroids are effective but relapses are recurrent. The prognosis seems to correlate with the severity level of granulomatous vasculitis and scope of necrosis.