This editorial carries the same title as an article recently published by Rusch 1 on mediastinal staging in lung cancer. In that article, the well-known thoracic surgeon presented the promising advances made in the assessment of the mediastinum thanks to the development of new technology that she believed would limit the future of mediastinoscopy. To date, mediastinoscopy has been considered the gold standard sampling method in the histologic evaluation of the mediastinum. However, this method of examination is far from ideal. Mediastinoscopy is a surgical technique and as such requires an operating room, an anesthesia team and a minimum hospital stay, all of which significantly increases the cost of health care. Moreover, mediastinoscopy is certainly not free of complications, some of which are serious and even fatal. The sensitivity of mediastinoscopy is 85% and specificity 100%, but most of the 10% of false negatives are so because the affected lymph node station was not reached. 2 It is therefore good to remember that mediastinoscopy is a technique with a clear learning curve.