<p>Destroyed lung is a radiographic and clinical end-stage condition of chronic pulmonary infection, characterized by irreversible parenchymal destruction and major functional impairment. Medical treatment may control active infection, but established structural damage is usually irreversible. Pneumonectomy remains the conventional surgical option for selected patients with unilateral destroyed lung, although it is associated with considerable perioperative risk. Lung transplantation may be considered only in highly selected patients with end-stage disease, bilateral involvement, severe functional compromise, or failure of conventional resection-based strategies. However, it should not be regarded as a routine substitute for pneumonectomy. This narrative review summarizes the major etiologies, clinical manifestations, and surgical approaches to destroyed lung, with particular attention to the selective role, indications, technical challenges, and limitations of lung transplantation in this setting.</p>