Purpose of the Review <p>This review focuses on the anesthetic and postoperative management challenges in the ventilation of patients with obesity. It highlights the increased perioperative respiratory risks and the need for a tailored approach in this patient population.</p> Recent Findings <p>Recent studies have highlighted the benefits of video laryngoscopy and apneic oxygenation in the intubation procedure of patients with obesity. Protective lung ventilation with low tidal volumes according to predicted body weight, titrated positive end-expiratory pressure, and intermittent recruitment maneuvers should be applied in these patients. After extubation, preventive noninvasive ventilation has shown efficacy in patients with obesity, when compared to standard oxygen therapy or high flow nasal oxygen therapy.</p> Summary <p>Patients with obesity are at high risk of perioperative pulmonary complications. The ventilatory management of patients with obesity needs to be anticipated before the induction of anesthesia, and to be pursued after extubation. Other challenges remain to be addressed in future studies.</p>