Central lung cancer refers to the location of the tumor next to the hilar structure, which includes important organs such as trachea, bullae and large blood vessels of the heart. Therefore, when people mention central lung cancer, the first reaction is terrible, inoperable and incurable. In fact, this is not entirely true. First of all, we need to confirm whether patients with central lung cancer have metastases in other parts of the body, and then we also need to evaluate whether there are metastases in the contralateral hilum and mediastinal lymph nodes. Some patients with locally advanced central giant lung cancer have achieved long-term high-quality survival through complex surgery, whereas some patients with seemingly small, early-staged tumors do not survive long after surgery and develop metastases very early. Some tumors can grow to a large size (for example, some locally advanced lung cancers) without distant metastasis, which means that this tumor is mainly locally invasive and not easily metastasized into blood; some tumors invade blood vessels and metastasize distantly when the diameter is very small, and the prognosis is extremely poor, which means that this tumor is easily disseminated and metastasized. Of course, the surgical operation of central lung cancer is generally more difficult. In recent years, with the improvement of surgical instruments and life support equipment, thoracic surgeons with formal multidisciplinary training, through surgical innovation, combined with cardiovascular surgery and lung transplantation techniques, can perform relatively safe complete resection of the invaded large blood vessels, trachea and other important structures and apply artificial or autologous materials for reconstruction. New surgical techniques such as traditional tracheal cuff resection, arterial cuff resection, superior vena cava replacement and emerging autologous lung transplantation and bloodless pneumonectomy have broken through the traditional surgical exclusion zone. Combined with the rapid progress in postoperative comprehensive treatment in recent years, a significant proportion of these patients, who were previously considered to have no hope of cure, have been able to achieve high quality of life and long-term survival. A large body of national and international literature shows that the 5-year survival rate of patients with locally advanced lung cancer exceeds 30% after surgery. It is important to emphasize that preoperative staging evaluation and postoperative adjuvant therapy for locally advanced centrally located lung cancer are extremely important. The majority of these procedures are performed in large, experienced medical oncology centers. Having central lung cancer is not the end of a hopeless journey, but perhaps the beginning of a new life.