Objective To investigate the clinical features, imaging features and pathological features of cryptogenic organizing pneumonia, so as to improve the understanding and diagnostic level of this disease. Methods A total of 20 patients with cryptogenic organizing pneumonia treated from January 2010 to January 2017 in our hospital were selected. The clinical results based on the high resolution CT (HRCT) and pathological examination were compared and comprehensive analysis was conducted. Results The cryptogenic organizing pneumonia was commonly seen for the female patients aged over 40; the major clinical symptoms included cough, expectoration, asthma after the physical exercises, anhelation, etc. According to the HRCT manifestations, there were 18 cases of bilateral pulmonary disease, among them, 11 cases were multifocal solid degeneration, 3 were glass opacity and 4 were multiple nodules. Pulmonary function diffusion limited, most of the white blood cells increased, CRP increased. The antibiotic therapy was not effective. The hormone drugs were effective, for instance, the clinical effective rate of glucocorticoid was 100%. Within 1-2y of follow-up visits, the patient's disease was stably controlled. Conclusion For patients with cryptogenic organizing pneumonia, the typical CT manifestations include the distributions of consolidation, multiple lesions and bilateral lesions, subpleural distribution and broncho-vascular distribution, etc. According to the typical imaging manifestations, transbronchial lung lavage or CT guided percutaneous biopsy of the lung can be confirmed by pathological examination while some of the patients have to be confirmed through the open-lung biopsy.