Abstract： Objective:To improve clinicians′ understanding of pulmonary actinomycosis and emphasize the early diagnosis of histopathological evidence (such as bronchoscopic biopsy) for pulmonary actinomycosis.Methods:A case of pulmonary actinomycosis diagnosed by pulmonary blind examination under bronchoscope was reported." Pulmonary actinomycosis" was used as a searching method to retrieve CNKI database from January 2000 to June 2019.Results:A total of 196 articles were retrieved and 54 domestic cases with relatively complete clinical data were screened, added the case reported in this article, a total of 55 cases were reported in this paper.There were 39 males (70.9%) and 16 females (29.1%), male to female ratio was about 2.4∶1, and the age range was 20-77 years old.Clinical manifestations are cough, sputum, phlegm with blood, fever, chest pain, etc., accumulating single lung lobe, no specific imaging manifestations, the misdiagnosis rate of initial diagnosis as high as 74.5%, which can be confirmed by bronchoscopyand lung biopsy.High-dose penicillin shock therapy is the preferred treatment at present.The cure rate of 55 patients was 75.6%, which was lower than that reported before.Conclusions:Actinomycosis is rare in clinic and has no obvious specificity in clinical manifestation and laboratory examination.The rate of misdiagnosis is very high.The diagnosis mainly depends on histopathological evidence.Early diagnosis is beneficial to the recovery of patients.The decrease of cure rate may be related to drug resistance in the 21st century.