The thoracic cavity encompasses three vital organ systems: the lungs with the major airways, the heart with the major blood vessels, and the spinal cord. Therefore, traumatic injury to the thoracic cavity presents a unique clinical challenge to the anesthesiologist. Itstems from the gravity of the patients' situation, the need to rapidly diagnose and treat cardiopulmonary injuries, and to coordinatethese steps with a multidisciplinary trauma team. It is importanttobe well prepared and to review the fundamentals of securing an airway in many different traumatic scenarios. Good communication between team members is the key to a positive outcome. The anesthesiologist, therefore, may play a key role in airway management, diagnosis, respiratory management, and pain management throughout the perioperative continuum of the thoracic trauma patients' care.