OBJECTIVE Aim of the study was the assessment of thoracotomies performed for spine surgery. METHODS All patients undergoing spine surgery with thoracotomy between December 2004 and October 2007 were included and evaluated with regard to their age, gender, etiology, the level of the intervention and the types of procedures performed. RESULTS A total of 29 patients undergoing spine surgery were included. Mean age was 45 years (range: 6-75) and the female to male ratio was 9 : 20. Trauma (14 patients, 48 %) and malignancy (5 patients, 17 %) were the most frequent reasons for surgery. A total of 7, 8 and 14 patients were operated at T3-T6, T7-T10, and T11-L2 levels, respectively. A left thoracotomy was performed in all but three patients (n = 26). The most frequent procedure was corpectomy and stabilization (n = 25, 86 %). CONCLUSION An anterior approach with thoracotomy is needed for spine surgery in subjects with conditions such as lung cancer, trauma, hydatid cyst, etc. A good preoperative assessment of the vertebrae requiring intervention and the use of appropriate techniques for separating the diaphragm during thoracotomy may provide a good exposure up to the L3 level.