Objective. To study the risk factors of complications after wedge resection with subsequent pleurectomy. Material and methods. There were 454 patients diagnosed with spontaneous pneumothorax between 2018 and 2023. Surgical intervention was performed in 331 (72.9%) patients according to commonly accepted indications for prevention of recurrence. Risk factors were studied using regression analysis and directed acyclic graph (DAG) method to build predictive models. Results. The complication rate was 11.5% (n=38). The most common complications were intrapleural bleeding and prolonged air leak (3.9% and 3.6%, respectively). One-third of cases were classified as major complications according to the Clavien-Dindo classification in thoracic surgery and required pleural cavity drainage or debridement. Significant risk factors of postoperative complications were secondary pneumothorax (HR 4.009; 95% 1.147—14.013; p=0.030) and severe pleural adhesions (HR 4.258; 95% 1.134—15.991; p=0.032). Conclusion. Secondary pneumothorax and severe pleural adhesions are independent risk factors of postoperative complications.