Diving-related pulmonary effects are due mostly to increased gas density, immersion-related increase in pulmonary blood volume and (usually) a higher inspired PO₂. Higher gas density produces an increase in airways resistance and work of breathing, and a reduced maximum breathing capacity. An additional mechanical load is due to immersion, which can impose a static transrespiratory pressure load as well as a decrease in pulmonary compliance. The combination of resistive and elastic loads are largely responsible for the reduction in ventilation during underwater exercise. Additionally, there is a density-related increase in deadspace-tidal volume ratio (V_D/V_T), possibly due to impairment of intrapulmonary gas phase diffusion and distribution of ventilation. The net result of relative hypoventilation and increased V_D/V_T is hypercapnia. The effect of high inspired PO₂ and inert gas narcosis on respiratory drive appear to be minimal. Exchange of oxygen by the lung is not impaired, at least up to a gas density of 25 g/L. There are few effects of pressure per se, other than a reduction in the P50 of hemoglobin, probably due to either a conformational change or an effect of inert gas binding.