Lung transplant candidacy depends on multidisciplinary evaluation of absolute and relative contraindications, including advanced age, comorbidities, and infection risk, all of which influence post-transplant outcomes. Comprehensive pre-listing investigations assess organ function, cardiovascular status, and psychosocial readiness. Anesthetic consultation reviews perioperative risks including graft dysfunction, surgical complications, extracorporeal support, and intensive care. Rigorous evaluation and optimization improves candidate selection and postoperative outcomes.