Thymic malignancies are relatively uncommon tumours that display significant clinical, pathological, and molecular heterogeneity. Their management requires a multidisciplinary approach; because of their rarity, current indications are based on data from smaller, mostly institutional, series or retrospective analyses and controversies still exist. This article focuses on the principles of treatment of thymic malignancies. In the future, collaboration between many different institutions will open the opportunity to achieve a better understanding and management of the disease.