From March, 1985, to June, 1993, 244 patients with 345 episodes of spontaneous pneumothorax treated at Koryo General Hospital were reviewed. Most of the patients were male, and the ratio of male to female was 8:1. The average age of the patients with spontaneous pneumothorax was 32.8 years old. The site of pneumothorax was revealed left side in 53.3%, right side in 42.6%, and bilateral in 4.1%. The cause of pneumothorax were shown primary spontaneous pneumothorax in 73.4%, and secondary spontaneous pneumothorax in 26.6%. The underlying pathologic lesion in secondary spontaneous pneumothorax showed pulmonary tuberculosis in 56patients[86.1%], COPD in 4patients[6.2%], bronchial asthma in 2patients[3.1%], lung cancer in 2patients[3.1%], and pneumoconiosis in a patient[1.5%]. The usual clinical symptomes were dyspnea, chest pain and chest discomfort. Recurrence rate was as follow; 2nd episode 33.6%, 3rd episode in 26.8%, and above in 4th episode in 18.2%. All the patient of pneumothorax was treated as following; Closed thoracostomy tube drainage in 127patients, bullectomy in 88patients, lobectomy in 5patients, wedge resection in 2patients, conservative treatment with oxygen therapy in 21patients, and video assisted thoracoscopic bullectomy in a patient. The course of treatment of all of the patients were smooth and uneventful.