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 first the standard posterolateral thoracotomy, which has been the classic reference and then the muscle-sparing posterolateral thoracotomy. Surgical techniques, indications, pitfalls and tips are described. Discussion and an overview of the literature are developed.