Introduction: Lung transplantation is associated with severe pain, which can delay recovery. Systemic lidocaine has useful analgesic properties for managing acute pain, however little is known on its use after lung transplantation. Due to pharmacological alterations during the postoperative period, the use of analgesics implies a demanding process to avoid toxicity, so lidocaine may play a role in this scenario. In this sense, the purpose of this case report is to present the use of systemic lidocaine as an option for the management of acute pain when other analgesics have failed to do so.Case presentation: The case of a male patient with acute pain in the postoperative period of single-lung transplantation is presented. Opioids and non-opioid analgesics showed limited efficacy, so the systematic administration of lidocaine was decided. Systemic lidocaine was effective for pain control, functional recovery and opioid decrease during the postoperative period.Conclusions: Systemic lidocaine was a useful drug for postoperative pain management in lung transplantation, since it allowed adequate analgesia and lung function recovery with decreased use of opioids. This drug may be a component of multimodal analgesia in selected patients when other options have failed; however its routine use is not recommended.