In this short review focusing essentially on thoracic kyphoscoliosis, respiratory and cardiovascular abnormalities observed in different forms of this rib cage disorder are briefly described. Chest wall and pulmonary mechanics, respiratory muscles, gas exchange, pulmonary vasculature and regulation of ventilation can be markedly affected by kyphoscoliosis and a substantial growth of knowledge of these functional alterations has been allowed recently by new technological approaches. The pathophysiological process which leads to cor pulmonale and respiratory failure in some patients with kyphoscoliosis is analysed. The prognostic aspects of surgical and non-surgical management on pulmonary function are addressed.