A 64-year-old male with advanced pulmonary carcinosarcoma, was admitted into Shanghai Chest Hospital on November 8, 2018, complaining of chest tightness and shortness of breath for one week. After the patient had undergone palliative surgery and second-line chemotherapy, positron emission tomography-computed tomography (PET-CT) indicated high metabolic nodules in the operation area, and recurrence was to be considered. Multiple metastases on the right pleura, possible metastases of right hilar lymph nodes and encapsulated pleural effusion suggested progression disease (PD). In the third-line therapy, anlotinib was used for stable disease (SD), and progression-free survival (PFS) was up to 8 months. He was well tolerated during the treatment, and the quality of life was significantly improved. The overall survival (OS) reached 19 months. Pulmonary carcinosarcoma was rare clinically, with limited treatment options and poor prognosis. Anlotinib provided a safe and effective treatment for advanced pulmonary carcinosarcoma.