The aim of the present study was to analyze the risk factors of postoperative pulmonary complications (PPCs) of elective craniotomy for patients presenting with brainstem tumors or tumors adjacent to the brainstem. A total of 162 consecutive patients with a brainstem tumor or adjacent brainstem tumor undergoing elective craniotomy were included and monitored. Potential risk factors were identified by data collection and monitoring of the PPCs, as well as the performance of single factor analysis (using the chi(2) test). In addition, the independent risk factors of PPCs were screened by logistic analysis. A total of 39 cases of PPC were included in the current study, with an incidence rate of 23.9%. The analysis indicated that smoking history, previous pulmonary diseases, an American Society of Anesthesiologists classification >II and partial tumor resection were risk factors of PPC following an elective craniotomy. Smoking history and partial tumor resection were identified to be independent risk factors of PPCs.