One of the most noteworthy achievements in the contemporary epoch is lung transplantation which is a very difficult kind of transplantation because of complexity of the operation and coordination of diverse therapeutic teams to prevent infection, inhibit immune system to avoid recurrent rejections, and treat complications of the surgery. In Iran lung transplantation has been implemented since April 2000, but a general report of the outcome has not been published yet. This study explains the surgical methods, difficulties, and results of lung transplantations in Iran. The data were collected from patients’ files, clinical visits, and telephone interviews. Studied variables were method of the surgery, morbidity and mortality due to the surgery, final morbidity and mortality, and final outcome. Final outcomes were categorized into good, acceptable, and bad. The good result refers to a patient who suffered no major complication after the surgery and was completely satisfied. The acceptable result indicates patient’s satisfaction in spite of some remarkable complications after the surgery and bad result means no satisfaction of the patient from lung transplantation.21 patients underwent lung transplantation in a 10 year period. The first 5 patients were operated in Imam Khomeini Hospital (Tehran) and the rest 16 underwent the surgery in Massih Daneshvari Hospital. There were 13 males and 8 females with a mean age of 40.1 years (ranging from 18 to 64 years). 18 patients underwent transplantation of one lung via posterolateral thoracotomy, while 3 patients underwent transplantation of 2 lungs via bilateral transverse thoracotomy incisions (Clamshell). Pneumonectomy technique was carried out by ligating and cutting lobar branches of vessels and cutting the main bronchi 2 rings proximal to its bifurcation. Implant method consisted of bronchial anastomosis with continuous Vicryl sutures and vascular anastomosis with continuous Prolene sutures. From the 11 patients who did not survive after transplantation, 6 individuals expired because of technical problems like prolonged ischemic time and inappropriate preservation of the graft, while after 2004, only one death occurred due to technical problems. Two patients passed away after 9 and 10 months mostly due to poor socioeconomic condition which led them to ineffective therapy. From 10 survived cases, 9 patients had a good result and in one case an acceptable result was obtained. 13 complications were seen in 11 patients (52.3%) as below: arterial anastomotic stenosis (2 cases, 15.4%), bronchial anastomotic stenosis (1 case, 7.7%), suture site hematoma (1 case, 7.7%), bleeding of surgical site (2 cases, 15.4%), extensive cervical and thoracic emphysema (3 cases, 23%), and pneumothorax (4 cases, 30.8%). The outcomes of lung transplantation in Iran have improved during 2000 to 2008. Results of the surgery have been good in most cases of the survived patients. Surgical techniques of lung transplantation in Iran have been attained and implementation of this surgery is feasible in our country.