Multiple small lymph nodes in the mediastinum should be treated in different ways according to the specific causes of the disease. First, if multiple small lymph nodes in the mediastinum are caused by lung infection, anti-infective treatment should be strengthened. Sputum culture can be taken from the patient, and sensitive antibiotics can be selected according to the sputum culture, and if necessary, fibrinoscopy can be performed to promote the excretion of sputum to control the lung infection. The lymph nodes can slowly regress after the infection is controlled. If the lung tumor or mediastinal tumor causes multiple lymph nodes in the mediastinum, if the patient’s tumor can be removed, the tumor can be removed as soon as possible and combined with postoperative chemotherapy treatment can effectively remove the lymph nodes in the mediastinum. If the patient’s tumor is too large to be completely removed, the patient’s prognosis is often poor, so chemotherapy can be used to slow down the growth of the tumor and lymph nodes.