Lung ultrasound (LUS) is an important auxiliary examination method in enhanced recovery after surgery, and can evaluate perioperative pulmonary condition in a fast, timely and non-invasive manner. Based on recent literature, this review summarizes LUS examination methods and typical images, explores the feasibility of LUS to recognize perioperative atelectasis and how to evaluate the severity of atelectasis according to ultrasound images. The paper focuses on the monitoring of ultrasound-guided pulmonary ventilation, and the implementation of individualized protective strategy of pulmonary ventilation to reduce the incidence of pulmonary complication. It also analyzes the limits of clinical application of LUS, and discusses the non-alternative advantages of LUS in preventing and monitoring important changes in the respiratory tract in the perioperative period.