Objective To explore the value of the combined detection of soluble urokinase-type plasminogen activator receptor （suPAR） and CD8⁺T lymphocytes in the early diagnosis and prognostic prediction of chronic pulmonary aspergillosis （CPA）. Methods A total of 258 patients with suspected CPA who were admitted to the hospital from June 2021 to June 2024 were enrolled in this study. The serum suPAR levels and the percentages of peripheral blood CD8⁺T lymphocytes were measured in all the subjects. The receiver operating characteristic （ROC） curve was employed to evaluate the diagnostic value of suPAR alone and in combination with CD8⁺T lymphocytes for CPA. All the confirmed CPA patients were followed up for 6 months and then classified into the death group and the survival group based on their prognosis. The clinical data， suPAR levels， and CD8⁺T lymphocyte percentages were compared between the two groups. Cox proportional hazards regression analysis was utilized to identify the independent risk factors for poor prognosis in CPA patients. The ROC curve was applied to assess the prognostic value of the indicators. The Kaplan-Meier method was used to plot the survival curves， and the Log-rank test was carried out to compare the survival differences between the groups. Results Among the 258 patients， 212 were diagnosed with CPA， and 46 were diagnosed with non-CPA. The proportions of solid nodules and cavitary lesions， along with suPAR levels and CD8⁺T lymphocyte percentages in the CPA group， were significantly higher compared to those in the non - CPA group （P < 0.05）. ROC curve analysis indicated that the area under the curve （AUC） of the combined detection of suPAR and CD8⁺T lymphocytes for CPA diagnosis was significantly higher than that of single detection （P < 0.05）. During the 6 - month follow-up， 34 out of the 212 CPA patients died， resulting in a mortality rate of 16.03%. The death group had significantly higher age， proportions of diabetes and hypoproteinemia， suPAR levels， and CD8⁺T lymphocyte percentages than the survival group （P < 0.05）. Cox regression analysis demonstrated that suPAR and CD8⁺T lymphocytes were independent risk factors for poor prognosis in CPA patients （P < 0.05）. The AUC of combined detection for predicting poor prognosis of CPA was significantly higher than that of single detection （P < 0.05）. Kaplan-Meier survival curves showed that patients with suPAR ≤ 8.090 ng/ml or CD8⁺T lymphocytes ≤ 23.846% had significantly longer survival time than those with suPAR > 8.090 ng/ml or CD8⁺T lymphocytes > 23.846% （Log-rank χ2 = 59.004， 16.078， P < 0.001）. Conclusions The combined detection of suPAR and CD8⁺T lymphocytes holds significant clinical value in the early diagnosis and prognostic evaluation of CPA. It can serve as a reliable quantitative indicator for the clinical assessment of CPA patients.