Objective To investigate the clinical characteristics of COVID -19 complicated with Pneumocystis pneumonia (PCP). Methods Medical record of a patient with PCP confirmed by pathological examination of bronchoalveolar lavage fluid during convalescence period of COVID -19 were analyzed, the relevant literatures were searched and reviewed. Results A total of 99 literatures were retrieved, 19 of which were case reports of COVID -19 combined with PCP. COVID -19 combined with PCP mostly occurred in critically ill patients with T-cell immunosuppression, and PCP occurred in 2 convalescent patients. Most clinical manifestations were fever, dry cough and dyspnea in varying degrees, laboratory examination showed elevation of serum 1, 3-β-D-glucan, chest imaging showed multi-lobe ground-glass infiltration, small reticular changes, consolidation, cyst-like lesions and pneumothorax. It was difficult for CT to distinguish whether COVID -19 was complicated with PCP, combined with sputum/bronchoalveolar lavage fluid Grocott's silver staining, immunofluorescence microscopy, polymerase chain reaction and serum 1, 3-β-D-glucan, the accuracy of Pneumocystis detection could be effectively improved. Compound sulfamethoxazole (TMP/SMZ) was the first choice for the treatment of PCP, dapsone, clindamycin and capofungin also had effective clinical efficacy. Conclusion Patients with severe COVID -19 and their convalescence period are at risk of PCP, but early identification is difficult. TMP/SMZ is the first choice for PCP treatment, combination therapy with dapsone, clindamycin and caspofungin can also be adopted.