Locally-advanced non-small cell lung cancer benefits from multimodal treatment approaches, with surgery playing a pivotal role. Advances in diagnostics and neoadjuvant therapies have increased complete resection rates and expanded surgical indications, even for previously unresectable cases. Resectability assessment requires precise staging, experienced surgical expertise, and multidisciplinary collaboration, especially in complex scenarios involving T4 tumors or N2 lymph nodes. High-volume specialized centers are crucial for optimal outcomes. Key challenges include defining resectability, minimizing surgical complications, and determining the best strategies for integrating surgery into evolving treatment paradigms, highlighting the importance of tailored multidisciplinary care.