ObjectiveTo summarize the experience of diagnosis and surgical treatment for solitary pulmonary nodules (SPN). MethodsWe retrospectively analyzed clinical data of 327 patients with video-assisted thoracoscopic surgery (VATS) lung resections and subsequent pathological diagnosis of the SPNs in Daping Hospital from January 2008 through May 2014 year. There were 183 males, 144 females at age of 56.6(20-79) years. ResultsOne way analysis of variance showed that there were significant differences in age, smoking index, diameter, glitches, lobulation, traction of pleural, cavity, vascular convergence, calcification between benign and malignant lesions (P<0.05). Logistic regression analysis revealed that age (P=0.004, OR=1.084), diameter (P<0.001, OR=1.467), glitches (P=0.001, OR=8.754), lobulation (P<0.001, OR=10.424), traction of pleural (P=0.002, OR=6.619) were independent predictors of malignancy in patients with SPN. Operation time was 121.4±47.6 min. Blood loss was 105.3±57.8 ml. Postoperative hospital stay was 7.3±2.4 days. Diagnostic accuracy was 99.7%. Incidence of complication was 0.5%. Five (1.5%) patients were converted to thoracotomy and no perioperative death occurred. ConclusionsAge, diameter, glitches, lobulation, traction of pleural are independent predictors of malignancy in the patients with SPN. VATS is a safe and efficient method for diagnosis and treatment of SPN.