The object of the study was a reassessment of the old but still widely accepted apophthegm that recurrent nerve palsy prohibits surgery in patients with pulmonary cancer. Out of 1,279 patients admitted over a 10-year period with proven or suspected pulmonary cancer, 23 were found to have recurrent nerve paralysis. Eleven of these were found inoperable by the preoperative work-up while 12 underwent thoracotomy. In three cases it was possible to perform a left upper lobectomy, which was considered to be radical both macro- and microscopically in two cases. The conclusion is that paralysis of the recurrent nerve, as might be foreseen, gravely worsens the prognosis, inverting the usual ratio of 80:20 between resections and exploratory thoracotomies. This, however, leaves a small group which will benefit from surgery, particularly considering the lack of alternative therapy.