Although there has been a significant increase in ambulatory surgery activity, there is still great potential for an increase in outpatient thoracic surgery. Video-assisted mediastinoscopy, lung biopsy, and bilateral thoracic sympathectomy can be accomplished safely in a significant percentage as ambulatory patients. The impact of the economical benefit of an outpatient thoracic surgical program over the conventional hospitalization depends on the previous department’s policy on hospital stay. Further experience is needed to increase the substitution index and expand the outpatient thoracic surgical program to other procedures.