Objective: To summarize the experience of postoperative care and treatment after bilateral massive whole-lung lavage simultaneously to cure severe pulmonary alveolar proteinosis (PAP) supported by cardiopulmonary bypass. Methods: From 2011 to 2013, 4 patients suffered from severe PAP were treated by bilateral massive whole-lung lavage simultaneously supported by cardiopulmonary bypass in our department. We investigated the postoperative care and treat interventions. Results: No death occured in hospital. Other common complications after procedures such as delayed recovery of respiratory function, lower limb ischemia, hypoxia, bronchospasm and hypokalemia were all healed before discharge. Conclusion: It is safe and feasible to treat severe PAP by bilateral massive whole-lung lavage simultaneously. Intensive peri-operative care、advisable postoperative treatment plan、to deal with complications promptly all contribute to improved outcomes.