Abstract: Objective To investigate the accuracy and safety of preoperative CTguided coil localization of subcentimeter solitary small pulmonary nodule（SPN）and followed by videoassisted thoracic surgery（VATS）resection under radioscopy. Methods From March 2014 to April 2015， 53 patients with subcentimeter SPN underwent CT-guided coil localization of SPN and VATS resection under radioscopy were retrospectively reviewed. Results The SPNs were localized and resected with success rate of 100％. The complications associated with procedure included 4 pneumothorax， 2 local parenchymal hemorrhage and 1 hemopneumothorax. Twentyone nodules were confirmed as malignancies， including 16 well differentiated adenocarcinoma， 3 minimally invasiveadenocarcinoma and 2 metastatic lesions. Thirtytwo nodules were confirmed as benign lesions， including 12 chronic granulomatous inflammation， 10 inflammatory fibrosis， 5 atypical adenomatous hyperplasia， 3 sclerosing hemangioma， and 2 harmatoma. Two patients suffered from pulmonary infection， and recovered by conservative treatment. The postoperative hospital stay was 3-7 d，with average length of stay （4.11±1.03）d. Conclusion CT-guided coil localization followed by VATS resection under radioscopy can be an effective and safe procedure for accurate resection and diagnosis of subcentimeter pulmonary nodules.