Lateral thoracotomies include many different variants with a common final pathway, consisting of an intercostal incision. They are the most frequent incisions in daily thoracic procedures. We will describe the lateral muscle-sparing thoracotomy in the Weissmuller's position which is, according to us, the universal thoracotomy. Surgical techniques, indications, pitfalls and tips are described. Discussion and an overview of the literature for this incision are developed.