Lung cancer causes the highest number of cancer-related death in China. Complete surgical resection is currently the best treatment modality for lung cancer. However, only one third of patients with lung cancer can be identified as candidates for operation. The other two thirds are inoperable, because they have late disease with distant metastasis or locally advanced lung cancer involving neighboring organs. Recently introduction of the theory and technique of cardiovascular surgery into lung cancer surgery has made possible en bloc resection of the lung combined with part of the involved left atrium, aorta, superior vena cava, and pulmonary artery. It has made possible for the patients with locally advanced lung cancer, who were thought as surgical contraindication or incurable cases, to not only have complete resection of the tumor, but also achieved long term survival and good life quality without evidence of recurrence and distant metastasis of the cancer.This paper will provide a brief background at the progression of surgical theory and technology of locally advanced lung cancer in China. Besides, the indication, present methods, results of surgical management and multimodality treatment for locally advanced lung cancer, including extended resection and reconstruction of superior vena cava, left atrium, aorta and pulmonary artery will be presented. Finally, the perioperative management for the extended resection of locally advanced lung cancer will also be discussed.