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Objective To observe surgical safety for patients whose pulmonary functions manifest were obstructive ventilatory dysfunction. Methods The data of totally 122 patients with obstructive ventilatory dysfunction in their perioperative period, such as hospital stays, hospital costs, treatment methods and postoperative pulmonary adverse events, had been collected and analyzed. The influnce of different airway medications and different grades of obstructive ventilatory dysfunction on the above date were compared. Results According to the result of regression analysis, airway management medication had a highly significant negative correlation with postoperative pulmonary adverse events (b=-0.807, P<0.001) and hospital stays (b=-1.906, P=0.003), and adverse events decreased significantly if the patients were medicated in their airways before and after surgery compared with neither before or after surgery (P=0.013). There was no significant difference in the 4 study endpoints (postoperative pulmonary adverse events, hospital stays, ICU stays, hospital costs) among different groups of obstructive ventilatory dysfunction (P=0.240, 0.755, 0.360, 0.320), and the patients with severe obstructive ventilatory dysfunction were medicated more actively. While different groups of surgical type had significant difference of the 4 study endpoints (P all <0.001). Conclusions Airway management medication is the most essential factor of surgical safety for patients with obstructive ventilatory dysfunction. Even though preoperative pulmonary function manifests as severe obstructive ventilatory dysfunction, patients can go through the operation safely by effective airway management. [ABSTRACT FROM AUTHOR]