Bethlehem Lungwort prefers consistently moist soil, especially during dry spells and its active growing season in spring. Ensure good drainage to prevent root rot. Reduce watering slightly after flowering or if foliage begins to die back in summer heat, but do not allow the soil to completely dry out.

Prune Bethlehem Lungwort after flowering by removing spent flower stalks to encourage neatness and prevent self-seeding. In late summer or autumn, if foliage becomes tattered or affected by powdery mildew, cut it back to the ground to promote fresh, healthy growth the following spring.

Propagate Pulmonaria saccharata by division in early spring or autumn when the plant is not actively flowering. Carefully dig up the entire clump, then gently separate it into smaller sections, ensuring each new division has a healthy root system and at least a few growing points. Replant these divisions immediately at the same depth as the original plant and water thoroughly to help establish them.

Container-grown Bethlehem Lungwort benefits from repotting every 2-3 years in early spring. Choose a pot slightly larger than the previous one and use a high-quality, well-draining potting mix rich in organic matter. This refreshes the soil and provides space for root expansion.