We report 3 cases of pulmonary aspergilloma treated by cavernostomy and simultaneous removal of fungus balls to eliminate their symptoms. They presented with hemoptysis and prolonged fever with cavitary lesions in their lungs. It was difficult to perform pulmonary resection for them, because of their high age, low respiratory function, and poornutrition. Treatment with anti-fungal agents, obtained no marked effects and thier symptoms were unchanged. Therefore we carried out cavernostomy and simultaneous removal of fungus balls for symptom management. After the surgical treatment, not only did their symptoms improve, but also we were able to maintain good symptom control for a long time. The burden of the surgery on the patients was light and no complications ensued. We strongly believe that cavernostomy and removal of the fungus ball is one of the useful treatment strategies for the patients with pulmonary aspergilloma who are high risks for pulmonary resection and/or who are poorly controlled with anti-fungal chemotherapy.