The follow-up and management of lung transplant recipients can be challenging. Early perioperative complications are generally related to technical aspects of the surgery. Later postoperative complications may involve one or more organ systems and include the management of graft dysfunction. Infections are a major cause of morbidity and mortality after lung transplantation. The predominant pathogens include bacteria, fungi, and viruses, of which cytomegalovirus plays a major role. Rejection of the allograft remains the major limitation to long-term survival of patients and may be divided into 3 categories: hyperacute, acute, and chronic rejection. Adequate management of the immunosuppressive regimen is essential, with appropriate attention to drug interactions and individual toxicities.