Objective: To compare the application effect of central venous catheter closed thoracic drainage and conventional thoracentesis for spontaneous pneumothorax. Methods: 64 patients with spontaneous pneumothorax were divided into observation group and control group by random number table method (32 cases each). The observation group was treated with closed thoracic drainage with central venous catheter and the control group was treated with conventional thoracic puncture. The therapeutic effect, lung reopening time and complications were compared between the two groups. Results: The total effective rate was 90.63% in the observation group and 56.25% in the control group, there was a significant difference between the two groups (P<0.05). The occurrence rates of pneumothorax, mediastinal emphysema, pleural effusion, secondary infection and pain in the observation group were significantly lower than those in the control group (P<0.05). The lung recruitment time and hospital stay in the observation group were significantly shorter than that of the control group, and the hospitalization costs were significantly lower (P<0.05). There was no significant difference of recurrence rate between one month and two months after treatment in both groups (P>0.05). However, the recurrence rate of the observation group at 3 months after treatment was significantly lower than that of the control group (P<0.05). Conclusion: The effect of central venous catheter closed thoracic drainage in the treatment of spontaneous pneumothorax is better than that of the conventional thoracentesis, and the former has simpler operation, less trauma and fewer complications.