Objective To investigate the clinical characteristics of pulmonary nocardiosis in order to improve its awareness for physicians. Methods Clinical data of 13 pulmonary nocardiosis patients admitted in our hospital and the Hainan Branch of our hospital from August 2009 to June 2016 were collected and retrospectively analyzed. Clinical characteristics were summarized and relevant literature was reviewed. Results There were 12 out of 13 patients having underlying diseases, and 7 patients had received corticosteroid and/or immunosuppressive agents. Cough was the most common symptom (84.6%). Radiological findings showed that 11 cases (84.6%) were manifested as lung nodules/masses, 9 (69.2%) as consolidation, and 8 as cavitary lesions (61.5%). Among them, 84.6% were misdiagnosed initially. The mortality was quite high in those with multiple organ dissemination. Combination therapy based on sulfanilamide resulted in sound clinical outcomes. Conclusion Pulmonary nocardiosis has no specific clinical manifestations, and its diagnosis can be frequently missed or delayed. The patients with multiple organs dissemination involved have poor prognosis. So for the patients having susceptible factors, this disease should be considered when conventional therapy is not effective.