Wind instrument performance is a notable feature in pneumology under aspects of ventilatory physiology and respiratory diseases. It requires an adequate ventilatory function combined with precise control of air flow and the ability to generate sufficient mouth pressures. Depending on the type of wind instrument, the required rates of airway pressure and air flow differ significantly. The cause of respiratory disease in wind instrument players may be related to these increased airway pressures in terms of a barotrauma. Wind instrumentalists may suffer from hemoptysis, laryngoceles, velopharyngeal insufficiency and pneumoparotitis due to their musical performance. Even the development of lung cancer has been assumed to be related to wind instrument playing. Controversy exists about implicating wind instrument use as the cause of pulmonary emphysema or in changes of pulmonary function, which is, however, unlikely under physiological aspects. Furthermore, professional wind instrumentalists may be impaired in their work by the side effects of anti-obstructive medication and respiratory infection. On the other hand, the potential therapeutic effects of wind instrument performance have to be considered. For asthmatic teenagers a significant improvement of pulmonary function and of physical and emotional activities could be related to wind instrument playing. Last but not least, didgeridoo playing was shown to be a promising alternative treatment for obstructive sleep apnoea syndrome.