Introduction & Objective: Transhiatal esophagectomy is one of the most popular surgical approaches to esophageal carcinoma which has been reintroduced and advocated by Orringer during the past two decades. Despite avoidance of thoracotomy which is considered as its main advantage, pulmonary complications are recognized as the most common cause of morbidity and mortality following this operation. Considering the high prevalence of esophageal carcinoma and frequent use of the Orringer technique in Iran and lack of comprehensive reports focusing on postoperative complications, the undertaking of an assessment in this regard was useful and necessary. Materials & Methods: In this descriptive study, 122 patients with esophageal cancer who were treated by Orringer transhiatal esophagectomy during a six - year period, in Al-Zahra Hospital, Isfahan, were assessed. Data were analyzed using SPSS v. 11.05 software and descriptive statistics indices. Results: Postoperative pulmonary complications included: respiratory failure in 38%, pleural effusion in 35%, pneumothorax in 24%, hemothorax in 17%, Pneumonia in 10% and empyema in 2%. Conclusions: These results indicate a high prevalence of pulmonary complication, following transhiatal esophagectomy and are comparable roughly to other surgical centers through out the world and can be used as a useful guide for choosing the appropriate surgical approach and the avoidance of postoperative complications in esophageal carcinoma.