During thoracic operation, one-lung ventilation (OLV) is often used to facilitate surgical field exposure. As we know, OLV is a “double-edged sword”, it causes imbalanced ventilation-perfusion ratio(V/Q) and may result in lung injury to varying degree either. Until now, anesthesiologists are troubled to balance the contradiction between them, especially when the compensatory ability of the dependent lung is limited, contradictions are particularly prominent. While the dependent lung is ventilated, the independent lung is ventilated either but with an appropriate tidal volume, in consequence, lung injury may be alleviated by the reduction of the fraction of inspired oxygen and improvement of V/Q, etc. This method is often used in the intensive care unit as a rescue treatment for specific lung diseases. Herein, the mechanism of OLV related lung injury will be discussed, as well as the rationale for protective role, advantages and application prospects of independent lung ventilation.