Abstract: Objective To investigate the relationship between the expression of ezrin protein,IL-18 and the survival of osteosarcoma pulmonary metastasis. Methods Forty-four patients with osteosarcoma specimens were selected and the expressions of ezrin protein and IL-18 in the tissue of osteosarcoma were detected by immunohistochemical.All patients were followed up for 3 years.The survival and progress of the disease were recorded. Results Ezrin positive expression rate(76.47%) in Preoperative patients with pulmonary metastasis were higher than preoperative patients without pulmonary metastasis(29.63%),and the differences was statistically significant(P<0.05).Preoperative patients with pulmonary metastasis and ezrin expression positive in the process of follow-up of 6 cases with pulmonary metastases,lung transfer probability is 75.00%,higher than that of preoperative patients without pulmonary metastasis and the expression of ezrinnegative,and the differences was statistically significant(P<0.05).IL-18 positive expression rate(64.71%) in Preoperative patients with pulmonary metastasis were higher than preoperative patients without pulmonary metastasis(37.04%),and the differences was statistically significant(P<0.05).In patients with pulmonary metastasis preoperatively,IL-18 masculine and feminine emerged during the follow-up of patients with pulmonary metastasis rate were 40.00% and 47.06%,respectively,and the differences had no statistically significant(P>0.05).Ezrin positive expression of 3 year survival rate was significantly lower in patients with negative expression of patients,and the differences was statistically significant(P<0.05).IL-18 positive expression of 3 year survival rate was significantly higher in patients with negative expression of patients,and the differences was statistically significant(P<0.05). Conclusion Ezrin protein expression and IL-18 positive related to the progress and pulmonary metastasis of osteosarcoma.