The patient was a middle-aged male who presented with left-sided chest pain and tightness with no obvious cause 3 months ago, without fever, cough and sputum, and no obvious respiratory distress. He had a past history of smoking for many years. Chest examination revealed slightly low breath sounds in the left upper lung. After preoperative preparation, he underwent bilateral pneumonectomy under general anesthesia with double lumen tracheal intubation on December 1, 2011, and first underwent pneumonectomy on the left side, during which a large isolated pulmonary herpes was seen in the left upper lung. The position was changed to the left lateral position, and the right upper lung herpes resection was performed without any problems. Discussion: Bilateral pulmonary bullae are not uncommon, and giant pulmonary bullae have a significant impact on the relatively normal lung tissue expansion, and patients can experience more pronounced chest tightness and shortness of breath. Localized pulmonary bullae surgery is effective, and bilateral pulmonary bullae resection surgery during the same period can address the heavier side first, and the position of the drainage tube after surgery is important to avoid compression of the chest drainage tube in the lateral position during the implementation of the contralateral surgery.