Abstract: Objective To evaluate the efficacy and value of a single -lumen central venous catheter in the treatment of the first unilateral spontaneous pneumothorax in young- and middle-aged patients. Methods The clinical data of 115 young- and middle-aged patients with developed first unilateral spontaneous pneumothorax in our hospital between January, 2013 and June, 2017 were retrospectively analyzed. The patients were divided into three groups based on the different treatment styles. Group A (n=45) underwent the placement of a single-lumen central venous catheter connected to a water seal bottle and cured with closed thoracic drainage; Group B (n=36) received single-lumen central venous catheter to extract gas; and group C (n=34) underwent traditional thoracic closed-chest drainage. The differences in therapeutic effects and complications including pleural reaction, blockage, lumen loss, infection, bleeding, subcutaneous emphysema, pain, air leakage among the three groups were analyzed. Results The effective rate was 6.67%, 5.56%, 32.35% in group A, group B and group C, respectively, there was no significant differences (P>0.05). The total incidence of complications of groups A, B, and C were 97.78%, 100.00%, and 97.06%, respectively. The incidence in groups A and B were significantly lower than that in group C, and the difference was statistically significant (P<0.05). Conclusion The single -lumen central venous catheter has important application in young- and middle-aged patients with first unilateral spontaneous pneumothorax. Its curative effect rate is similar to that of traditional thoracic closed-chest drainage, but the total incidence of complications is significantly lower. Besides, it has many advantages such as small wound, simple operation and easy accepted by patients, and its application value in clinic is worth further study.