Broncholithiasis complicated with actinomycosis is a rare clinical disease. This paper reports a patient presenting cough and shortness of breath as the major symptoms. The diagnosis of broncholithiasis complicated with pulmonary actinomycosis was confirmed by chest CT, fiberoptic bronchoscopy, and biopsy of the lesion. The broncholiths in the anterior segment of the right upper lobe were removed by repeated lavage, cryotherapy as well as the use of electrocautery snare and forceps under general anesthesia intubation bronchoscopy. After combined with anti-infection treatment, the patient’s cough and shortness of breath improved significantly. Combined with reviewing the literature, this paper explores the pathophysiological mechanism, clinical manifestations, diagnosis and treatment of broncholithiasis complicated with actinomycosis, aiming to enhance the understanding and treatment of this disease.