Lung transplantation has developed in China for nearly half a century. The Wuxi lung transplant team completed our first lung transplantation on September 28, 2002. By the year of 2021, the total number of lung transplantation in China has been increased to 775, while 49 medical centers have been qualified to perform lung transplantation. During the past two decades, we vigorously promoted lung transplantation technique, cooperated and communicated with colleagues in relevant specialties. Thus, more and more patients with end-stage lung diseases could be evaluated and transplanted to save their lives, with the support of medical insurance and funds. The full-process monitoring and staged objective management, have been well established regarding to donor evaluation standards and acquisition procedures, the green channel for organ transportation, postoperative intensive care unit management, prevention of rejection and infection, as well as long-term follow-up of recipients. Based on the classical lung transplantation surgical techniques, technical breakthroughs have been made while the public’s acknowledgement of lung transplantation has been also enhanced. In the future, lung transplantation techniques will be increasingly challenged by new technologies and ethics, bringing diversified opportunities and challenges to the lung transplantation team collaboration.