In 1986, with the assistance of senior experts from the Department of General Surgery, a specialized group of Cardiothoracic Surgery was established within the Department of General Surgery, with Professor Zhou Guanhan serving as the first academic leader. Professor Zhou Guanhan was one of the first group of 13 medical professionals publicly dispatched by New China to visit the United States. He devoted tremendous efforts to the establishment of the department, undertaking extensive work in areas such as personnel arrangement, technical capacity building, bed allocation, procurement of specialized instruments, and patient referral sources. Starting with the first radical resection for cardia cancer in September 1986, the department's annual surgical volume increased to 100 procedures over a span of five years. In 1991, in response to the developmental needs of Cardiothoracic Surgery, the department was independently established as a separate discipline. Dr. Liu Dandan served as the acting department director, leading the entire team to continue exploring, conducting in-depth research, pioneering innovation, and working actively within the field. As one of the first units in China to perform video-assisted thoracoscopic surgery (VATS), the department successfully performed its first VATS bullectomy for pulmonary bullae in March 1994. In 1995, the first VATS procedure for transabdominal hiatal hernia repair was performed, and sleeve lobectomy was also successfully carried out during the same period. Over time, the department's clinical operations gradually became more diversified, advanced, and complex, laying a solid foundation for its continued development. In accordance with the overall medical development needs of the hospital, in 2000, the Department of Thoracic Surgery introduced a key clinical and academic leader—Dr. Yan Tiansheng, Chief Physician and PhD from the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College—who assumed the role of department director, marking the beginning of a rapid development phase for the department. The discipline's distinctive positioning was defined as "dual advancement of thoracic oncology and minimally invasive surgery," while simultaneously building and developing the academic team based on the principle of "department-specific strengths and individual expertise." In the fields of thoracic oncology and minimally invasive thoracic surgery, the department closely followed cutting-edge international and domestic treatment techniques and theories, vigorously promoted new technologies, and drove the robust development of the discipline. Clinically, the department introduced techniques including sleeve lobectomy of the main bronchus and lobar bronchus for lung cancer treatment, tracheal sleeve resection for tracheal tumors, VATS lung volume reduction surgery for severe emphysema, VATS lobectomy, VATS for palmar hyperhidrosis, VATS extended thymectomy for myasthenia gravis in elderly patients, right-thoracotomy single-incision high-level esophagectomy with supra-thoracic apex anastomosis, and hand-assisted VATS esophagectomy with left thoracic arch supra-arch anastomosis, ushering thoracic surgery into a brand-new era of minimally invasive techniques. In 2013, the talent echelon construction of the Department of Thoracic Surgery was further strengthened. Director Yan Tiansheng recruited Associate Chief Physician Ma Shaohua from Beijing Cancer Hospital, further expanding the department's capabilities. In the same year, combined thoracoscopic and laparoscopic radical esophagectomy was initiated with favorable outcomes, accumulating over 150 cases to date and receiving widespread recognition from peers. Significant progress was also made in VATS procedures, including standardized single-direction VATS lobectomy, VATS sleeve resection, VATS anatomical segmentectomy, single-port VATS lobectomy, VATS pneumonectomy, and Hook-Wire-guided precise resection of pulmonary nodules, elevating VATS technology to a new platform. Concurrently, the Peking University Third Hospital Thoracic Surgery Minimally Invasive Forum was launched, with a cumulative total of 15 sessions and trainees spanning nationwide, reaching 600 participants. Currently, the department aims to achieve comprehensive development and enhancement in the three areas of clinical service, education, and research, ensuring steady clinical progress while prioritizing research and clinical translational studies, striving toward becoming a research-oriented department. The Department of Thoracic Surgery undertakes clinical teaching responsibilities for Peking University Health Science Center and serves as a standardized training base for clinical physicians and a specialized training base for thoracic surgeons, as well as a high-quality nursing ward and an Enhanced Recovery After Surgery (ERAS) demonstration ward. The Thoracic Surgery Minimally Invasive Forum is held annually, attracting trainees from across the country. From basic to clinical research, scientific work is continuously expanding, with multiple patents obtained and pending, alongside ongoing clinical translation efforts. The Department of Thoracic Surgery possesses comprehensive clinical expertise, performing nearly all categories of thoracic surgical procedures with continuous innovation. It is among the first units in China to initiate thoracoscopic minimally invasive surgery and is also one of the earlier institutions in Beijing to adopt robot-assisted surgery. To date, over 100 robot-assisted procedures have been performed, including various lobectomies, segmentectomies, sleeve lobectomies, esophagectomies, and mediastinal tumor resections. In terms of conventional endoscopic surgery, with a primary focus on thoracic oncologic surgery, the department performs lobectomy, segmentectomy, combined segmentectomy/subsegmentectomy, anatomical pulmonary resection, and sleeve resection, utilizing various approaches ranging from uniportal to multiportal techniques. The department was among the earlier units in Beijing to perform minimally invasive esophagectomy, accumulating extensive experience. For mediastinal tumors, procedures include subxiphoid and other approaches for thymectomy, extended thymectomy, and innominate vein reconstruction. Additionally, the integration of anchor-wire localization, preoperative three-dimensional reconstruction, and fluorescence thoracoscopy ensures safe and efficient surgical outcomes. In the field of non-oncologic surgery, the department has also accumulated rich experience in the treatment of pneumothorax and complex pneumothorax, correction of chest wall deformities, and internal fixation of traumatic rib fractures. Adhering to advanced treatment concepts, as a member of a large comprehensive hospital, the department engages in multidisciplinary collaboration and leads the multidisciplinary team (MDT) for lung cancer, conducting neoadjuvant therapy and comprehensive patient management throughout the disease course. For the increasingly prevalent elderly patient population with multiple comorbidities, individualized treatment plans are provided. **Departmental Features** The department has achieved full coverage of mainstream minimally invasive thoracic surgical procedures, including but not limited to: thoracoscopic lobectomy, segmentectomy, subsegmentectomy, combined subsegmentectomy, pneumonectomy, and sleeve lobectomy; uniportal VATS minimally invasive surgery; Hook-Wire-guided precise resection of small pulmonary nodules; minimally invasive combined thoracoscopic and laparoscopic esophagectomy; subxiphoid mediastinal mass resection; and Da Vinci robot-assisted surgeries for various procedures—encompassing nearly all advanced minimally invasive thoracic surgical approaches.