We here report two cases of chronic necrotizing pulmonary aspergillosis (CNPA) treated with itraconazole oral solution (ITCZ-OS). These two cases had a history of pulmonary tuberculosis and Mycobacterium kansasii infection, respectively. Bloody sputum and cough appeared after these diseases had finished, and chest computed tomography showed infiltration around the cavity with a fungus ball in it. Two cases were diagnosed as having CNPA with the symptom and CT findings in addition to biomarker and sputum culture. ITCZ-OS was chosen as a first-line therapy mainly because of economic reasons. It is less expensive and has higher AUC (area under the curve) than ITCZ capsule formulation. All symptoms were cleared after an eight-month therapy in both cases. Follow-up CT showed improvement of infiltration and fungus balls with biomarkers normalized. Minor tolerance side effects were observed during the course. This report first shows the efficacy and safety of ITCZ-OS in CNPA treatment.