One hundred and fifty-seven patients underwent surgery for pulmonary metastases in our hospital between 1977 and 1985. Potentially curative surgery was possible in 96 cases. We recorded survival rates of 60% after 3 years and 43% after 5 years. The median survival time was 47 months. When compared to radical surgery, the 5-year survival rate for patients treated by palliative operations was less than 6%. The preoperative diagnostic examinations do not permit an exact determination of the number of metastases and their localization. When comparing the suspected number of metastases with the number determined during surgery using sternotomy we found an underestimate in 40% of the patients with suspected solitary metastasis and in 85% of the patients with multiple metastases. We therefore recommend median sternotomy with exploration of both pleural cavities and lungs as standard access also for patients with suspected solitary metastasis.