Resection of the chest wall for lung cancer by definition indicates locally advanced disease. Complete en bloc removal of the tumor and thorough surgical staging is paramount for offering the best treatment and increasing the chances of prolonged survival. Thorough knowledge of all the reconstructive techniques available is critical to allow appropriate operative planning. A multidisciplinary approach including involvement of plastic and spinal surgery expertise should be considered when planning a large resection. Repairs should give structural stability while maintaining functional capacity of the thorax. Respiratory and wound complications are the most frequent postoperative issues.