Percutaneous cervical cordotomy (PCC) is a recognized procedure for control of pain due to thoracic malignancies. Caution with PCC in those with precarious lung function has previously been advised. Thirty-five patients were studied in a prospective study of respiratory function before and after PCC for control of pain from pleural mesothelioma or other thoracic malignancy using standard, easily applied tests. Mean duration of survival was 83 days (range 3-360 days). FEV1.0 and FVC did not alter significantly after the procedure. There was no relationship between any of the respiratory function variables measured and survival. Transient nocturnal hypoxemia occurred during the night immediately following PCC in 6 patients. Unilateral PCC does not worsen respiratory function in patients with pleural mesothelioma or other thoracic malignancies. Poor respiratory function before PCC does not predict survival or complications. It should not be a barrier to use of PCC.