Postoperative pulmonary complications remain one of the leading causes of morbidity and mortality following major thoracic and cardiac surgery. In these patients, postoperative diaphragmatic dysfunction, atelectasis, hypoxaemia, secretion retention, and a reduction in functional residual capacity markedly compromise pulmonary reserve. These pathophysiological alterations impair gas exchange, increase the work of breathing, and consequently lead to a significantly elevated risk of developing acute respiratory failure in the postoperative period. Non-invasive ventilation (NIV) has emerged as an important therapeutic strategy in the prevention of postoperative pulmonary complications, owing to its potential to reduce the need for endotracheal intubation and to optimise gas exchange. NIV is increasingly employed both prophylactically and therapeutically following cardiac, thoracic, and abdominal surgeries. However, positive pressure-based ventilation techniques present certain limitations in clinical practice due to their adverse effects on hemodynamic parameters, patient discomfort associated with mask use, and loss of efficiency caused by air leakage. In this context, the recently developed Biphasic Cuirass Ventilation (BCV) system has attracted increasing attention, as it provides a hemodynamically stable and physiologically natural form of ventilatory support by externally applying alternating negative and positive pressure phases to the thoracic wall without the need for a mask. Owing to these features, BCV is considered a promising novel non-invasive ventilation approach for preserving both pulmonary and cardiac function in the postoperative period. This book chapter discusses the potential role of BCV as a novel NIV modality in the postoperative period.