The perioperative management of thoracic surgical patients is a significant challenge that requires close collaboration between the anesthetist and thoracic surgeon, as these often involve complex surgeries in multimorbid patients. The anesthetist must be familiar with the physiology of the lungs and respiration, the pathophysiology of pulmonary diseases, as well as one-lung ventilation and the safe use of fiberoptic techniques. Knowledge of the theory and practice of thoracic anesthesia is thus an essential part of the anesthetist's toolkit and also part of the training curriculum for specialists. This work provides less experienced anesthetists with an introduction and practical tips while not neglecting scientific evidence. The specific knowledge of thoracic anesthesia is presented in a concentrated, practice-oriented, and yet comprehensive manner.