Abstract: One lung ventilation (OLV) has been widely used in cardio-thoracic surgery, and has obvious advantages. However, lung injury caused by OLV has gradually attracted the attention of clinicians. Changes of respiration by OLV, and effects of intraoperative posture, gravity, and manipulation in operation lead to complications such as imbalance of ventilation to blood flow ratio, inflammatory stress reaction, hypoxemia, atelectasis and so on. Protective lung ventilation can significantly relieve lung injury related to ventilation, but there are many factors affecting the successful clinical application of lung protective ventilation strategies. In this paper, the progresses in pathogenesis and protective strategies of OLV-related lung injury were summarized to provide better strategies for patients in perioperation.