Abstract: Objective To analyze clinical diagnosis and treatment of 22 patients with thoracoscopic lung cancer complicated with chylothorax, compare the difference of chylothorax after Single-operated thoracoscopic and multi-hole thoracoscopic surgery, and summarize the diagnosis and treatment of chylothorax after thoracoscopic lung carcinoma surgery. Methods The clinical data of 22 patients with chylothorax after thoracoscopic lung cancer surgery in 1 305 cases from May 2015 to May 2018 were retrospectively analyzed. Results A total of 22 patients with postoperative chylothorax were identified among 1 305 patients who underwent thoracoscopy lung carcinoma surgery (1.69%), with 9 males and 13 females, aged 36-79 years old with an average age of 66 years old; 17 cases of chylothorax after single-operated thoracoscopic surgery in 926 cases (1.84%), 12 cases on the right side, 5 cases on the left side； 5 cases on the right upper lobe lung cancer, 1 case on the right middle lobe lung cancer, 6 cases on the right lower lobe lung cancer, 2 cases on the left upper lobe lung cancer, 3 cases on the left lower lobe lung cancer；and 5 cases of chylothorax after multi-operational thoracoscopic surgery in 379 cases (1.32%), 1 case of right upper lobe lung cancer, 3 cases of right lower lobe lung cancer, 1 case of left lower lobe lung cancer； the difference was not significant (P＞0.05). And 22 patients were cured,21 cases cured by conservative treatment with nutrition support and pleural fixation, and 1 patient was cured by the thoracic ligation of the thoracic duct trunk with the effect which was not accurate after 2 days conservative treatment, with a total cure rate 100% (22/22). Conclusions There was no significant difference in chylothorax after single and multi-operational thoracoscopic for lung cancer. The diagnosis of chylothorax after thoracoscopic lung cancer is not difficult. The correct treatment should be taken after the occurrence of chylothorax. Most chylothorax can be cured by conservative treatment. Surgical treatment should be decisive for patients with inconsistent conservative treatment or poor tolerance to nutritional lose. The overall therapeutic effect was satisfactory.