Purpose <p>A variety of treatments options for pulmonary ground glass nodules (GGNs) are currently under investigation. This study aimed to retrospectively compare the safety and efficacy of two therapeutic concepts, radiofrequency ablation (RFA) and thoracoscopic sublobar resection, in the treatment of patients with resectable pulmonary GGNs.</p> Materials and Methods <p>This bi-center retrospective study included patients with resectable pulmonary GGNs who received either thoracoscopic sublobar resection or percutaneous computed tomography (CT)-guided RFA. Patients’ clinical outcomes were compared between the two groups.</p> Results <p>Between November 2019 and June 2023, a total of 71 patients were included, with 34 patients undergoing CT-guided RFA after refusing surgery, and 37 patients receiving thoracoscopic sublobar resection. No local recurrence or distant metastasis was observed in either group during the follow-up period (24 (interquartile range, 17.5–34.0) months for sublobectomy group and 30 (interquartile range, 17.5–38.75) months for RFA group). Compared to the thoracoscopic sublobar resection group, the RFA group had significantly fewer postoperative complications according to the Clavien-Dindo classification, particularly a lower incidence of pleural effusion (<i>P</i> &lt; 0.001). The overall hospital stay length was also significantly shorter in the RFA patients (1&#xa0;day versus 8&#xa0;days, <i>P</i> &lt; 0.001).</p> Conclusions <p>This limited series suggests that percutaneous CT-guided RFA may be a safe and effective treatment option for patients with resectable pulmonary GGNs who refuse surgical intervention.</p> Graphical Abstract <p></p>