To discuss the innovations in general thoracic surgery and how they affect anesthetic management perioperatively. However, rather than listing various thoracic procedures and their inherent issues that complicate providing anesthesia, the approach of this article is to raise the anesthetic issues associated with innovations in thoracic surgery perceived to be important by the thoracic surgeon.Recently, there have been advances in thoracic surgery that have necessitated a joint approach to the preoperative, intraoperative, and postoperative management of patients undergoing thoracic procedures. Substantial forethought and collaboration have resulted in the successful adoption of many new and innovative advances in thoracic surgery.Innovations in thoracic surgery continually emerge and challenge thoracic surgeons and anesthesiologists to evaluate their utility and benefits. The increased adoption of minimally invasive operations is a testament to this collaboration. This process requires an ongoing dialog between the clinicians within these two disciplines to advance the science of surgery.