Background: pneumonectomy is associated with a higher operative morbidity and mortality. Is most commonly performed for treatment of surgically resectable lung cancer but is sometimes necessary to treat benign diseases like pulmonary tuberculosis and cystic bronchiectasis associated with pulmonary impaired pulmonary function. Higher morbi-mortality imposed that anesthesiologists and thoracic surgeons must both be rigorous on the management of pneumonectomies. It is also imposed the institution of analgesia and physiotherapy in the post-operative in the objective to warm complications after lung resection. Objectives: the purpose of this study is in the one hand to determine the epidemiological particularities of patients and to evaluate the quality of the coverage, on the other to propose of care adapt to our context which contains the entire new concepts in the field of anesthesia and surgery recommendations by the international societies. Methods: we retrospectively reviewed the database for patients underwent a pneumonectomy from January 2009 to December 2013 in HASSAN II CHU in FEZ. Results: there were 43 patients, 29 men (67, 44%), with a mean age of 43,49 years (24- 70). Antecedents were dominated by tuberculosis and smoking. Indications for pneumonectomy included pulmonary tuberculosis (18 patients), broncogenic carcinoma (18 patients), bronchiectasis (3 patients), aspergilloma (2 patients) and traumatic pulmonary injury (2 patients). Functional respiratory evaluation showed a mean VEMS at 60% (29% – 109%). Thoracic epidural analgesia was performed on 24 patients and paravertebral block on 5.One lung ventilation was performed by double-lumen tube. Hemodynamic instability occurred on 20 patients and hypoxia on 3. Postoperative respiratory complications occurred on 10 patients and mortality on 14%. Conclusion: our conviction is that a good knowledge of the patients characteristics in our context, an optimization of preoperative cardio-respiratory condition and a control of the new concepts of anesthesia adapted to the thoracic surgery can bring profits in the perioperative management of the patients and reduce the morbi-mortality of pneumonectomy