Introduction: Bullae are thin-walled, air filled intraparenchymal lung spaces caused by the loss of alveolar structural tissue. Giant bulla refers to the one that occupies more than 30% of the hemithorax. After the thorough clinical and radiological assessment, patients with bulla can be taken up for surgeries like local excision/bullectomy, lobectomy, segmental resection, and minimal access surgery technique with laser and videoscopy.
Case presentation: An atypical case of a 48-year-old female with a giant bulla measuring 14.2 x 9.7 x 13.7 cm almost completely involving left lung with passive collapse of left upper lobe, managed successfully using lung isolation technique and a well planned post-operative pain management.
Conclusion: Anesthetist should consider an extensive preoperative evaluation to identify the high risk factors, reversibility of underlying lung disease and stratify a successful perioperative management with a smooth, pain free post-operative recovery in such patients.