Postoperative pulmonary complications (PPC) are considered a main factor increasing postoperative morbidity and mortality. Medical history and clinical examination are highly predictive for the development of PPC. Extended evaluation is indicated in the presence of pulmonary symptoms. Prophylaxis of PPC includes cessation of smoking, antiinfectious measures, optimization of bronchodilator therapy and improvement of cardiac performance. Regional anesthesia is favorable in the presence of bronchial hyperreactivity and for postoperative pain therapy. Postoperative course includes early extubation besides positioning, relief of intrabdominal pressure and physiotherapy.