Lung cancer surgery has evolved from its recent past when it was performed through a large thoracotomy primarily by cardiac surgeons at the end of the day when the other cardiac cases had finished. The modern practice of lung cancer surgery involves a comprehensive pre-operative work-up utilizing both PET and CT scans, often in conjunction with pre-operative endobronchial ultrasound and biopsy for accurate pre-operative clinical staging. Surgery for early lung cancer should involves a minimally invasive approach using eithe thoracoscopic or robotic technique and should include a full lymph node dissection. Surgery for late lung cancer should be contemplated after discussion at a multi-disciplinary lung tumor board often in conjunction with neoadjuvant chemo and radiation therapy to the lesion and mediastinum.