To elucidate the clinical features of Aspergillus infections with underlying pulmonary disease, we analyzed 79 cases with positive results for anti-aspergillus antibody. The patients were 69 men and 10 women. Mean age at diagnosis was 68.0. Positive rates for isolation of Aspergillus spp. from the airways, and of galactomannan antigen and 1, 3-beta-D glucan in the serum were 44.3, 21.8, 26.5%, respectively. These findings did not show any differences according to underlying pulmonary disease. Twenty-nine patients died of the disease. Body mass indices, serum albumin levels and red blood cell counts were significantly lower in the patients who died. Extension of the lesion to the lower lobes or to 3 or more lobes was correlated significantly with poor survival. A specific diagnostic tool was required for early detection of the disease.