In summary, from the different alternatives to conventional hospitalization developed in the last decades, outpatient surgery has been the one with the greatest growth. However, only few studies have been reported on thoracic surgery and there is still great potential for an increase in outpatient thoracic surgery. The aim of this article has been to evaluate the clinical aspects, results, and economical impact of an outpatient thoracic surgery program (OTSP). Video-assisted mediastinoscopy, lung biopsy, and bilateral thoracic sympathectomy can be accomplished safely in a significant percentage of cases as ambulatory patients. The impact of the economical benefit of outpatient thoracic surgical program over the conventional hospitalization depends on the previous department's policy on hospital stay. Further experience is needed to increase the substitution index and expand the OTSP to other procedures.