In a previous communication from Fitzsimons Army Hospital, 13 patients with focalized pulmonary coccidioidomycosis treated surgically were reported on.1Our experience now has encompassed a total of 50 patients, including the original 13. The present report deals with information gleaned from these 50 case problems, with emphasis on the nature of the lesion, complications of surgery, and a formulation of the surgical rationale. Coccidioidomycosis is a highly infectious specific fungus disease that until recent years was seen only in the endemic area of the Southwest, which is now known to include southern California, New Mexico, Arizona, western Texas, the Mexican border, and parts of southern Nevada and Utah.2During and since World War II it has been observed in almost every section of the country and is most commonly seen among military personnel and dependents who were stationed temporarily at one of the several large military training establishments