The standard posterolateral thoracotomy has been used for many decades in a great number of thoracic operations. The procedure during which the lateral thoracic wall muscles - the latissimus dorsi and the serratus anterior - are being spared, represents an alternative approach. Since 1997, our department undertook 53 posterolateral thoracotomies in a random sample of patients, whereas the serratus anterior muscle, as well as the greatest part of the latissimus dorsi muscle, have been spared. During this type of thoracotomy, the skin incision is identical to the standard procedure, the latissimus dorsi muscle is partially divided and the serratus anterior muscle is mobilized, after its posterior margin is identified and his posterior fascia divided and thereafter, the hemithorax is entered through the 4th, 5th or 6th interspace. By sparing the serratus anterior muscle, as well as the greatest part of the latissimus dorsi muscle, faster patient recovery, while postoperative pain and use of analgetics, as well as duration of hospital stay are descreased. The time required for exposure of the chest cavity is increased, resulting in a decrease of closing time. In conclusion, the muscle-sparing posterolateral thoracotomy technique offers many advantages regarding postoperative patient recovery, pain, as well as duration and cost effectiveness of hospital stay. We strongly believe that it may be a reasonable alternative to the standard posterolateral approach. Pneumon 2001, 14 (1): 47-50