CT-guided percutaneous pulmonary puncture is a minimally invasive technique for localizing pulmonary nodules prior to resection. Systemic gas embolism is a rare but potentially catastrophic complication. The article describes three cases of patients under general anesthesia for resection of small lung lesions after such localization. In the first case, intraoperative cardiac arrest occurred, the patient recovered after cardiopulmonary resuscitation and delayed surgery. The second patient had postoperative hemiplegia and dysarthria with partial neurological recovery after one month. The third patient received immediate treatment, vital functions remained stable without sequelae. General anesthesia can mask early signs of embolism. Isolation of one lung with a double-lumen tube, low CPAP on the operated lung, minimal needle passage, and CT control after puncture are recommended, along with multidisciplinary coordination and administration of 100% oxygen.