Pulmonary arteriovenous fistulas are routinely treated with interventions in our cardiovascular surgery department with satisfactory results. A typical case is attached. The patient, male, 15 years old, was admitted to the hospital with “chest tightness and shortness of breath after activity for 6 months”. On examination: no heart murmur was heard, but a continuous murmur was suspiciously heard in the right lung, which was enhanced by deep inspiration, and pestle-like fingers (toes) were visible. Chest radiograph: a mass-like shadow of the right lung was seen, CT suggested: pulmonary arteriovenous fistula in the middle lobe of the right lung. The saturation was 91% for both sedentary non-oxygenated and oxygenated fingertips. The diagnosis of “pulmonary arteriovenous fistula” was made in combination with the symptoms, signs and ancillary tests. An individual interventional treatment plan was developed. After the necessary preparation, interventional embolization of the pulmonary arteriovenous fistula was performed under local anesthesia. Under local anesthesia, the femoral vein was punctured, and the main pulmonary artery and selective pulmonary artery branches were first imaged in different positions. A large pulmonary arteriovenous fistula was seen in the middle lobe of the right lung, about 35 mm * 45 mm * 45 mm, the diameter of the supplying artery was about 12 mm, and the length was about 14 mm. A 0.035 stiffened guidewire was fed into the fistula lumen, and a 10F delivery sheath was fed along the guidewire. A domestic 14/16 mm PDA blocker was selected and embolized after accurate positioning. Repeated selective imaging showed complete embolization, with no visualization of the sac cavity, and the blocker was appropriately sized and positioned without affecting the normal pulmonary artery branch flow (Figure 3), and the blocker was released. The blocking effect was satisfactory, and the finger-end saturation was 98% immediately after the procedure. There was no chest tightness or shortness of breath, and the patient was discharged 3 days after surgery. Pulmonary arteriovenous fistula (PAVF) is a rare malformation of pulmonary vascular development. It is an abnormal communication between the pulmonary artery and pulmonary vein, creating a high-flow, low-resistance right-to-left shunt. Patients may present with clinical manifestations such as cyanosis, pestle finger, dyspnea and paradoxical embolism. It can be complicated by hemorrhagic symptoms such as coughing up blood and hemothorax, as well as neurological symptoms such as concurrent brain abscess, hemiparesis and transient cerebral hypoxic attack. Surgery mostly uses ligation, local, lung segment, lobectomy or total pneumonectomy, etc., which is highly traumatic, easy to rupture and bleed from surrounding tissues, risky and must lose some lung functions. With the continuous development and maturation of interventional techniques and embolization materials, interventional embolization therapy is currently the safest and most effective method of choice for the treatment of PAVF because of its small trauma and precise efficacy. This patient has a giant PAVF, which is extremely rare. It is especially important to comprehensively assess its morphological characteristics by selective pulmonary angiography, and according to its characteristics, the surgeon chooses the best embolization blocking method and material. Treatment requires skilled, careful, gentle, and accurate surgical technique to maximize preservation of normal lung tissue blood supply while minimizing the occurrence of collateral circulation or PAVF rupture.