ObjectiveTo further understand the anatomical characteristics and rules of left upper lingual pulmonary artery.MethodsCT data of 120 patients (82 males, 38 females, median age of 65 years ranging 36-78 years) with pulmonary nodules from December 2018 to August 2020 in our hospital were retrospectively analyzed. The anatomic characteristics of the lingual segment of the upper left lung were analyzed by three-dimensional reconstruction. ResultsMediastinal lingual artery appeared in 34 of the 120 patients, accounting for 28.4%. There were 26 patientsof mixed mediastinal/interlobar type, 8 patients of pure mediastinal lingual artery, and 92.3% (24/26) mixed mediastinal/interlobar type blood vessel contained A4b. Fifty-eight (58/120, 48.3%) patients had interlobar type A4+5 type, the rest were two-branches type. And 22 patients of A4 and A5 type accounted for the most two-branches type (22/28, 78.6%). The single-branch type was located at the distal end of A6 in 54 (54/58, 93.1%) patients, originated from the proximal end of A6 in 4 patients, and originated from the basilar artery in 6 patients. The two-branches type was at the distal end of A6 accounting for 50.0% (14/28).ConclusionMediastinal lingual artery is more common than expected, accounting for 28.4%, among which mixed lingual artery is more prevalent, usually located in the first pulmonary trunk, and mostly follows the principle of proximity to supply relevant lung tissues. The location of the interlobar branches in the pulmonary trunk can be at the distal or proximal end of A6, care should be taken to avoid damaging adjacent structures.