Abstract: Lung transplantation is the only effective treatment for end-stage lung diseases. However, its long-term prognosis is affected by early and late complications, such as primary graft dysfunction, antibody-mediated rejection, and chronic lung allograft dysfunction. In recent years, the central role of the complement system in these pathological processes has gradually gained attention. As a novel immunomodulatory strategy, complement inhibitors are still in the exploratory phase in lung transplantation. Therefore, this article reviews the pathological mechanisms of the complement system in primary graft dysfunction, antibody-mediated rejection, and chronic lung allograft dysfunction. Combined with existing clinical cases, it analyzes the potential role and limitations of complement inhibitors in improving lung allograft function and proposes future research directions and suggestions. The aim is to provide a reference for the precise intervention of lung transplant complications and the improvement of lung transplant outcomes.