The author have had experience with seven cases of acute pulmonary edema. There are many predisposing factors for acute pulmonary edema, namely, left ventricular failure due to cardiac disease or overloading, hypoalbuminemia, pulmonary capillary endothelial damage from bacterial infections, toxins or irritant gases, rarely central nervous system injuries and pulmonary hypersensitivity reactions. For these presented cases, we believe that overloading, hypoalbuminemia, bile pneumonitis were the causative factors. There are many preventive measures and treatment for acute pulmonary edema. We conclude that prompt recognition and attention by the anesthesiologist are the most important preventive measures.