OBJECTIVE: Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is a rare lung malignancy occurring most frequent-ly in young non-smokers from Southeast Asia. Given its low incidence, PPLELC clinical fea-tures, treatment methods, and the factors af-fecting its prognosis remain elusive. To date, PPLELC data are mainly derived from clinical case reports, and no cohort studies are avail-able. Therefore, we retrospectively analyzed a group of PPLELC cases and summarized the clinical features of patients, treatment respons-es, and the factors affecting patient prognosis.PATIENTS AND METHODS: A total of 91 patients having primary pulmonary lymphoep-ithelioma-like carcinoma were recruited in this study. These included sex, age, place of birth, smoking history, pre-treatment symptoms, tu-mor location, tumor markers, maximum tumor diameter, treatment regimen, lymph node pres-ence metastasis after an operation, pathological picture, immunohistochemistry, genetic find- ings, and tumor stage grading. We determined the overall survival (OS), progression-free sur-vival (PFS), basic clinical characteristics, treat-ment option, treatment response, and recur-rence pattern among the patients. In addition, we understood the influence of sex, age, tumor, nodes, and metastases (TNM) stage, tumor size, and surgery over patient prognosis.RESULTS: Primary pulmonary lymphoepithe-lioma-like carcinoma is more common among young non-smokers, with a slightly higher in-cidence in women than in men. The expres-sion of Epstein-Barr virus-encoded small RNA (EBER), pancytokeratin (PCK), Cytokeratin 5/6 (CK5/6), and tumor protein 63 (P63) was positive in immunohistochemistry. Serum cytokeratin 19 fragment antigen (CYFRA21-1) and Epstein-Barr DNA (EB-DNA) could be used as markers to diagnose primary pulmonary lymphoepithelio-ma-like carcinoma. TNM stage and surgery were independent prognostic factors.CONCLUSIONS: Primary pulmonary lympho-epithelioma-like carcinoma is rare, showing a good prognosis.