Among patients undergoing general anesthesia and mechanical ventilation, 5% to 40% will experience varying degrees of postoperative pulmonary complications (PPCs) . The lung protective mechanical ventilation strategy (LPVS) is considered as an effective measure to alleviate ventilator-induced lung injury (VILI) and reduce the incidence of PPCs. However, a high incidence of postoperative pulmonary complications is still being observed even with a protective ventilatory strategy . Recent studies have shown that the occurrence and prognosis of PPCs may not be correlated with tidal volume (VT) and positive end expiratory pressure (PEEP) during intraoperative mechanical ventilation, but significantly with driving pressure. Individualized PEEP ventilation strategies guided by driving pressure, as a new lung protective strategy, can improve intraoperative lung function, reduce the incidence of PPCs, enhance recovery after surgery and reduce the economic burden on patients and society. This article reviews the impact of individualized positive end expiratory pressure guided by driving pressure on postoperative pulmonary complications, and introduces its application in different surgical types.