Objective: We aimed to investigate the security and feasibility of the simultaneous surgery for patients with both esophageal carcinoma and bullous emphysema. Methods: We described simultaneous surgery performed on 49 cases with both esophageal carcinoma and bullous emphysema, accounting for 2.5% of all esophagectomy patients from January 2000 to January 2003. Radical resection of upper and mid-thoracic esophageal cancer was performed in 31 cases, including three approaches from the right chest, left neck and midsection. Thirty-six patients were underwent cervical anastomosis and 13 cases were operated by intrathoracic anastomosis. Results: No perioperative period death occurred. And postoperative complications were as follows: cervical anastomotic leakage in 9 cases, lung infection in 11 cases, pulmonary air leak in 13 cases(2 cases lasted for 4 weeks), recurrent laryngeal nerve damage in 4 cases, supraventricular tachycardia in 4 cases. Patients all recovered and left the hospital with average hospitalization time of 17.5 days. Conclusion: Patients with both esophageal carcinoma and bullous can perform the esophageal carcinoma resection and lung volume reduction surgery(LVRS) simultaneously. It will not increase the mortality rate and show the feasibility and safety in patients. Objective: We aimed to investigate the security and feasibility of the simultaneous surgery for patients with both esophageal carcinoma and bullous emphysema. Methods: We describe simultaneous surgery performed on 49 cases with both esophageal carcinoma and bullous emphysema, accounting for 2.5% of all esophagectomy patients from January 2000 to January 2003. Radical resection of upper and mid-thoracic esophageal cancer was performed in 31 cases, including three approaches from the right chest, left neck and midsection. Thirty-six patients were underwent cervical anastomosis and 13 cases were operated by Results: No perioperative period occurred occurred. And postoperative complications were as follows: cervical anastomotic leakage in 9 cases, lung infection in 11 cases, pulmonary air leak in 13 cases (2 cases lasted for 4 weeks), recurrent laryngeal nerve damage in 4 cases, supraventricular tachycardia in 4 cases. Patients all recovered and left the hospital wi The average hospitalization time of 17.5 days. Conclusion: Patients with both esophageal carcinoma and bullous can perform the esophageal carcinoma resection and lung volume reduction surgery (LVRS) simultaneously. It will not increase the mortality rate and show the feasibility and safety in patients.