The standard surgical treatment of NSCLC remains lobectomy combined with lymph node (LN) dissection (LND), even for early stage tumors (1). However, there is a growing interest in sublobar resections (SLR), even in patients who can tolerate a lobectomy, as reflected by the increasing number of publications referenced in PubMed (2) as well as changing practices. Thus, in our department, the average rate of SLR varies between 25 and 35% (3). Trials comparing lobectomy and RSL are underway (4–6) and the favorable results of the JCOG-0802 study has recently been announced (publication pending at the time of writing this article). Until now, the published survival results of SLR have been less satisfactory than those of lobectomies. For several years, after the publication of the Lung Cancer Study Group comparing lobectomies and SLR, which showed poor results on local recurrence and survival, lobectomy has been considered the gold standard treatment (7). Subsequent cohort studies have confirmed this attitude. In particular, the SEER database study of over 14,000 patients with NSCLC demonstrated significantly better survival after lobectomy, regardless of tumor size (8). Surgeons have until now considered lobectomy to be the standard treatment for NSCLC–apart from cases requiring pneumonectomy for location reasons–not only because of the above-mentioned findings, but also to apply the recommendations and with the consideration that a lobectomy provides satisfactory safety margins and allows removal of the lymphatic networks and intralobar nodes. Several years ago, the presence of invaded interlobar nodes led to the extension of the resection to pneumonectomy. The poor oncological benefit and the high morbidity and mortality of pneumonectomies have led to abandon this dogma. However, many recent monocentric studies have demonstrated the non-inferiority, or even a slight superiority of SLR over lobectomies for early-stage NSCLC (9–13). Currently, more and more teams are performing SLR for selected early-stage tumors. Presumably, they apply, or should apply, the same oncological rules as for lobectomies, which have been clearly defined (14–16), i.e., performing a macroscopically complete resection with free margins and a systematic lymph node dissection, according to the guidelines (14). One of the questions is therefore why intersegmental LN dissection and analysis of the resection margins are not routinely performed during SLR for cancer. The latter point is not the subject of this article and we will focus here on lymph node dissection during SLR. The reasons for the possible inferiority of SLR compared to lobectomy, at least in some cohort studies, are the following (and these reasons can be correlated): (1) some SLRs are actually wedge resections, (2) insufficient resection margins, (3) low number of nodes being examined, (4) absence of analysis of the so-called “adjacent” nodes and (5) non-practice of frozen section on margins and on the segmental nodes, which does not allow for extension to lobectomy during the procedure (Positivity nodes on final pathological examination rarely leads to a reoperation). All in all, as emphasized by P. Thomas, lymph node dissection might be the key point in performing a “radical segmentectomy” (17). In this article, we will look at the four areas of concern and end-up with proposals.