In order to improve the detection accuracy of pulmonary nodules in CT image, considering two problems of pulmonary nodules detection model, including unreasonable feature structure and nontightness of feature representation, a pulmonary nodules detection algorithm is proposed based on SVM and CT image feature-level fusion with rough sets. Firstly, CT images of pulmonary nodule are analyzed, and 42-dimensional feature components are extracted, including six new 3-dimensional features proposed by this paper and others 2-dimensional and 3-dimensional features. Secondly, these features are reduced for five times with rough set based on feature-level fusion. Thirdly, a grid optimization model is used to optimize the kernel function of support vector machine (SVM), which is used as a classifier to identify pulmonary nodules. Finally, lung CT images of 70 patients with pulmonary nodules are collected as the original samples, which are used to verify the effectiveness and stability of the proposed model by four groups' comparative experiments. The experimental results show that the effectiveness and stability of the proposed model based on rough set feature-level fusion are improved in some degrees.