Abstract: Objective To discuss the clinical characteristic, diagnosis, surgical therapy and prognosis of primary pulmonary mucoepidermoid carcinoma (PMEC). Methods Clinical data about 23 patients with PMEC who underwent surgery in our hospital from July 2005 to July 2014 were retrospectively analyzed. Results All 23 patients with PMEC had accepted surgery, including 4 cases with pneumonectomies, 17 cases with lobectomies and 2 cases with exploratory thoracotomies. There were 7 patients with high-grade PMEC and 16 patients with low-grade PMEC. The median survival time of patients with high-grade PMEC (10 months) was shorter than patients with low-grade PMEC (44 months) (P< 0.01), and the constituent ratio of lymph node metastasis of patients with high-grade PMEC (71.4%) was higher than patients with low-grade PMEC (6.3%) (P< 0.01). Six patients with PMEC received postoperative chemotherapy. Conclusion Surgery is the only way to cure PEMC. The prognosis of PMEC depends largely on the degree of malignancy, patients with high-grade PMEC have poor prognosis.