Objective To explore the clinical features, bronchoscopic features and classification of pulmonary actinomycosis, in order to improve the understanding of the disease, the level of diagnosis and treatment.Methods The clinical history, imaging features, bronchoscopic manifestations and treatment methods of 65 patients with pathologically confirmed pulmonary actinomycosis in this center were retrospectively analyzed.Results The common chief complaints were hemoptysis and cough, and the imaging manifestations were lack of specificity; Bronchoscopy can show milky white pus, necrosis, new organisms, foreign bodies or stones calcification erosion infection, non-specific congestion, edema, etc, bronchoscopy or other forms of pathological biopsy can be diagnosed.Conclusion Pulmonary actinomycosis is easy to be misdiagnosed; Under bronchoscopy, there were latent phenotype, suppurative necrosis type, intraluminal mass type, organic erosion type and mixed phenotype. The cure rate was high after active antibiotic treatment or surgical treatment.