INTRODUCTION: Bronchopleural fistula (BPF) refers to a leakage of inspired air from airways into pleural space for more than 24 hours. Surgical procedures remain the leading cause of a BPF followed by ruptured bulla(e), necrotizing infections, radiation therapy, ARDS and iatrogenic1. Traditionally, BPF have been managed with thoracostomy, pleurodesis and surgical repair. Recently, endobronchial techniques have been used with success including fibrin glue, Amplatzer device, tracheobronchial stents and intrabronchial valves (IBV). We describe a case of refractory BPF treated with IBV placed using intraoperative mechanical ventilator flow dynamics.