The purpose of preoperative pulmonary assessment is to predict which p
atients are at greatest risk of pulmonary complications, under which c
ircumstances such complications may occur, and whether surgery should
be denied based on that risk, In this article, the author addresses th
e following major issues in preoperative pulmonary assessment: 1) the
risks of pulmonary complications in relation to the type of surgical p
rocedure; 2) the value of preoperative pulmonary function testing, inc
luding when such testing should be performed and how the results shoul
d be used; and 3) guidelines for assessment of those patients about to
undergo resectional surgery of the lung.