Objective To study the clinical effects of long-term low-dose clarithromycin on non-cystic bronchiectasis patients at different stages. Methods A total of 50 bronchiectasis patients at different stages were recruited, divided into two groups by severity, and each group were given oral clarithromycin of 0.25 qd for 4 months. The differences between the two groups of patients at the starting point and end point in sputum volume, dyspnea index, lung function related indicators as well as the hospital stay and hospital costs for acute exacerbation were compared. Results Sputum volume significantly reduced ( P<0.01) in the two groups of patients after treatment. Dyspnea index and indicators of lung function in relatively mild condition patients with FVC, FEV1 and PEF were improved ( P<0.05), however, critically ill patients had little improvement in addition to PEF. The time of hospitalization and hospital costs because of acute exacerbation in the two groups of patients were significantly reduced ( P<0.05) , compared with than in the past. Conclusions The treatment of long-term low-dose clarithromycin has significant benefits in reducing the amount of sputum in patients with bronchiectasis, and can improve lung function in patients with mild indicators. Joint use of the drug can reduce the length of stay and hospital costs to hospitalized patients.