BACKGROUND: Due to severe pain after open thoracotmy, the postoperative pain control is essential to decrease pulmonary complications, and improve a patient's recovery. This study compared the surgical outcome of patients who had undergone open thoracotomy, and been managed with two different analgesic methods. METHODS: A retrospective chart review was carried out regarding 81 patients who had undergone open thoracotomy due to lung cancer. 41 of these patients has received continuous thoracic epidural analgesia with 0.1% bupivacaine and 0.3 mg/ml morphine at a rate of 2 ml/hr for postthoracotomy pain control (CTEA group). The remaining 40 patients has received intravenous patient-controlled analgesia with 1% meperidine (IV-PCA group). We compared the effects of the postoperative pain control in the two groups and the outcomes, including the pulmonary complications and durations of hospital stay. RESULTS: There were no significant differences in demographic data between the two groups. Supplemental analgesic requirements and postoperative pulmonary complications were significantly lower in the CTEA group than in the IV-PCA group. There were no significant statistical differences between the two groups in the durations of their hospital stay. CONCLUSIONS: We conclude that the continuous thoracic epidural infusion provided better postthoracotomy analgesia and surgical outcomes than intravenous patient controlled analgesia.