**Abstract**

The management of primary and secondary spontaneous pneumothorax can have many variations depending on the surgeons and their expertise of practice. The end goal is to stop the recurrence. The history of treatment, clinical indications for surgery, and preoperative and postoperative decision-making for intervention are summarized. Surgical intervention plays an important role in the management of recurrent pneumothorax and complex initial pneumothorax. Over the years the surgical techniques have evolved, and currently, video-assisted thoracoscopic techniques are frequently used in the management. In this concise report, we attempt to analyze the surgical techniques currently in use and their outcomes. Furthermore, we attempt to integrate future innovations in the management of this common disorder.

**Keywords:** pneumothorax, video-assisted thoracoscopy, pleurodesis, thoracotomy
