Willie Nelson's Health Problems Explained

Willie Nelson is an undeniable country music legend who has delighted fans with hits like "On the Road Again" and "Always On My Mind" for decades. Even in his 90s, Nelson has defied the odds by touring and performing despite multiple health issues that have forced him to cancel appearances on more than one occasion. His well-known vices, including cigarettes, alcohol, and marijuana, have taken a toll on the singer. In fact, Nelson once believed smoking marijuana saved lives, but he has since given up the habit. "Well, I can't smoke anything anymore," he told Forbes in 2025. "My lungs have already said, 'Don't do that.' So, I don't really do anything now much except a few edibles."

Nelson, who released his 77th studio album in April 2025, was born in the small town of Abbott, Texas and raised by his grandparents. He got his first guitar when he was a child, and the rest is honky tonk history. The road to riches was paved with a stint in the Air Force, a few years at Baylor University, and unglamorous gigs that included selling encyclopedias, but music kept calling Nelson back. "I always knew that I wanted to do this," he said. And do it he did, becoming one of the industry's most beloved performers. In between Willie's many legal troubles and his tumultuous relationship with singer Shirley Collie Nelson, he has enjoyed a thriving music career. How has he done it after all these years? The singer believes it's all about positive thinking. "Imagine what you want and then get out of the way," he told Forbes. For all his positivity, however, there are many tragic details in Willie Nelson's life, including a slew of health problems that date back to the early '80s.

Rest and relaxation were what Willie Nelson was looking for while on a family vacation in Maui in 1981. At the time, he was married to Connie Koepke, the mother of Willie's talented daughter Paula Nelson. Taking a break from his grueling schedule that often included more than 200 appearances per year, Willie was enjoying the sun and surf when things took a frightening turn. While swimming, the singer experienced chest pains that were severe enough to send him to the local hospital. There, doctors determined that the then 48-year-old had suffered a collapsed lung. Maui Memorial Hospital administrator Jerry Walker told the Lakeland Ledger that doctors inserted a tube in the Farm Aid co-founder's chest to aid in drainage while the lung healed. "No surgery was required," he said. 

Although Willie's agent at the time, Mark Rothbaum, assured the Ledger that "it's not serious," the condition forced Nelson's team to cancel several upcoming concert dates while he recovered, an expensive proposition considering that he raked in as much as $50,000 per concert at that time. Woody Bowles of Nashville's CBS Records implied that Willie's tough touring schedule may have had a hand in his illness, but as the "Just Breathe" singer would later admit, his lungs took a lot of abuse from his years of smoking. "I've mistreated my lungs since I was [young]," he said in a 2019 interview with KSAT-TV in San Antonio (via Hello!). "I started smoking cedar bark, went from that to cigarettes to whatever. And that almost killed me."

Willie Nelson experienced every guitar picker's worst nightmare when he was diagnosed with carpal tunnel syndrome, a condition that can cause excruciating pain in the wrists, numbness in the fingers, and other issues. Although the severity varies from person to person, Nelson's pain was so intense that he was forced to end a 2004 concert in Las Vegas mid-show. It was then that the "Whiskey River" singer, who was 71 at the time, knew he had to do something about it if he wanted to continue to perform. "Willie Nelson will have surgery to relieve extreme pain caused by carpal tunnel syndrome," Carlos Larraz, a promoter with National Artists Corp., told CBS News. 

Recovery was slow for Nelson, but rather than pull the plug on his popular annual Fourth of July picnic, he decided to sing but not play guitar due to lingering soreness and swelling. "Naturally I'd love to play," the OG country-western star told Today in 2004, "but it hurts so much that I'm not yearning to play. I'm willing to wait until it's not hurting." Despite being relatively common, carpal tunnel system is a painful nerve disorder that is often caused by fast, repetitive movements of the hands and fingers, as is typically seen in piano playing and, yes, guitar picking. Many musicians, including Nelson's buddy Waylon Jennings, have suffered from it, but it's not unique to that industry. Artists, hair stylists, and anyone who works at a computer all day are all at potential risk. 

In 2012, Willie Nelson had to pull the plug on a benefit concert near Denver, Colorado due to breathing issues. "I was told Willie woke up and had trouble breathing, so he was taken to the hospital," fundraiser host Fred Bartlit told The Denver Post. Although reps for Nelson would not confirm whether or not he was hospitalized, or the specifics of his illness, his publicist Elaine Shock told E! News, "Willie's fine. His shows are gonna continue. This was the only one that was canceled. He's actually on the road to the next gig." Despite his rep's assurance that he was recovering nicely, and that the situation was the result of his environment, news caused concern among Nelson's legions of fans. "He's not going anywhere," she added. "It really was high altitude-related."

High altitude is not the type of high normally associated with the "Roll Me Up and Smoke Me When I Die" singer, so it wasn't a stretch for fans to assume that years of inhaling may have finally caught up with Nelson, who had reportedly struggled with breathing issues for decades. Their suspicions were further raised when the singer cut a concert short in Utah a few years later and took to X to once again blame his environment. "I am sorry to have to cut the SLC show short tonight," Nelson wrote. "The altitude got to me, I am feeling better now & headed for lower ground."

Like a cat with nine lives, Willie Nelson kept going strong despite his struggles with breathing issues. Pneumonia and emphysema, which is a type of chronic obstructive pulmonary disease (COPD), continued to plague the singer-songwriter, and in 2015, he decided to do something about it. Nelson cancelled yet more shows, but this time, it was to undergo a stem cell surgery to try and repair the decades of damage his lungs had sustained. "Over the years I've smoked a lot of cigarettes, and I've had emphysema and pneumonia four or five times, so my lungs were really screwed up, and I had heard that this stem cell operation would be good for them. So, I said, 'Well, I'm gonna try it out,'" he told The Washington Post at the time.

Stem cell lung surgery is performed by taking stem cells from other parts of the body and injecting them into the lungs, where they will work to repair and regenerate the damaged tissues. That may sound like a miracle cure, but the American Lung Association cautioned that it is highly experimental and not without adverse risks. "Until we know more, we are strongly concerned that the treatment could cause adverse effects and could worsen the patient's condition," the website states. As for Nelson, he said the procedure didn't concern him as much as the after effects. "The only thing that worries me more than anything is carrying my guitar, because they did the operation right in my stomach," he told The Washington Post. "But I think I'll be all right." 

In 2022, Willie Nelson was hit with Covid-19. At almost 90 years old, and with lungs that were already severely compromised, things escalated quickly for the "God's Problem Child" singer. After waking up in the middle of the night on his tour bus in Nashville, struggling to breathe, a rapid test revealed the worst, and his team flew into action. "I had a nebulizer on the bus," his wife Annie D'Angelo — the mother of Nelson's talented son Lukas Nelson — told The New York Times. "I started everything I could at that point, including Paxlovid. He had the monoclonal antibodies. He had steroids." D'Angelo, who is Nelson's fourth wife and the one he has deemed the love of his life, brought her husband home and oversaw his care. "We turned the house into a hospital," she said, and shared that she had a mobile medical unit come to the family's ranch. 

Nelson, who has often written songs that seem to mock death, came face to face with his own mortality. "I think trying to be creative, keeping busy, has a lot to do with keeping you alive," the state's favorite son once told Texas Monthly. However, after Nelson contracted the virus, D'Angelo recalled, "There were a couple of times when I wasn't sure he was going to make it." Nelson also spoke about how difficult it was for him at that time: "I had a pretty rough time with it. Covid ain't nothing to laugh at, that's for sure." That said, despite his age and preexisting health conditions, Nelson not only recovered, he was back on the road again just three weeks later.

In the summer of 2024, the cancellation of Willie Nelson's performances at the Outlaw Music Festival over health concerns once again had fans speculating that their hero, now in his ninth decade, was done. At this late stage of life, it wouldn't be too far off to assume that the emphysema, and the many other health issues that had troubled the singer for decades, may have finally gotten the best of him. But Nelson wasn't done. True to form, he said "hold my beer" and rallied yet again. In fact, the only thing that stopped him from the 2025 Outlaw Music Festival was damage to the band's gear from torrential rains. However, he does still live with emphysema, along with the aches and pains that come from a lifetime of performing. "His body aches and gives him pain, but he's determined to brave through it and keep on performing even if it kills him, which it just might do," a concerned pal dished to the National Enquirer (via Radar).

Nelson, for his part, hasn't listened to the naysayers and he sure hasn't let talk of his failing health bother him. "Well, I'm 91 plus, so, you know, I'm not worried about it. I don't feel bad. I don't hurt anywhere. I don't have any reason to worry about dying. But I don't know anybody who's lived forever. I take pretty good care of myself," the father of eight told the Associated Press in 2024. He jokingly added, "And I feel like I'm in pretty good shape physically. Mentally? That's another story."