Although a minor constituent by weight, surfactant protein B (SP-B) plays a major role in surfactant function. It is the unique structure of SP-B that promotes permeabilization, cross-linking, mixing, and fusion of phospholipids, facilitating the proper structure and function of pulmonary surfactant as well as contributing to the formation of lamellar bodies. SP-B production is a complex process within alveolar type 2 cells and is under hormonal and developmental control. Understanding the posttranslational events in the maturation of SP-B may provide new insight into the process of lamellar body formation and into the pathophysiology of pulmonary disorders associated with surfactant abnormalities.