Although tuberculosis is mainly managed medically today, thoracic surgery continues to play a key role in its diagnosis and treatment in selected subgroups of patients. In certain scenarios such as multi-drug-resistant tuberculosis, advanced tuberculous empyema and symptomatic bronchial stenosis, modern thoracic surgery may represent the only effective means of management in selected patients. Advances in thoracic surgery in recent years, in particular the use of Video-Assisted Thoracic Surgery, not only reduce postoperative morbidity for individual patients, but may potentially allow a wider range of tuberculosis patients to benefit from surgery. Respiratory physicians and thoracic surgeons should continue to work together to ensure that tuberculosis patients who may benefit from surgery are identified for prompt and effective intervention.