There are many complementary techniques for mediastinal staging of lung cancer. It is increasingly apparent that the accuracy of mediastinal staging depends not only on which test is used but also on technical factors of how the procedure is performed. This article reviews data regarding such technical factors and proposes a classification schema of the thoroughness of execution of mediastinal staging tests. Such a schema is needed for a thoughtful discussion of how mediastinal staging tests should be integrated and for the development of standards of good quality care for patients with non-small cell lung cancer.