Postoperative pulmonary complications (POPCs) such as exacerbation of preexisting lung disease, pneumonia, and/or respiratory failure are as prevalent as cardiac complications and contribute to morbidity, mortality, and increased length of hospital stay. Although more research is needed, currently the risk factors for POPCs can be broadly classified into patient related and procedure related. POPCs can be reduced in all types of procedures by identifying patients at risk, optimizing their medical therapy preoperatively, performing vigilant intraoperative care, and by delivering aggressive postoperative care emphasizing analgesia and lung expansion.