Although less studied than cardiac complications, postoperative pulmonary complications are frequent and serious after major surgery. A close team working between primary care physician, surgeon, anesthesiologist, lung and heart physicians is essential to prevent and reduce postoperative pulmonary complications. Preoperative evaluation focused on clinical data and choice of surgical and anaesthetic adapted techniques are the key elements for a better control of these risks. Postoperative lung expansion techniques can minimize rate and severity of respiratory complications.