Chest wall resection and reconstruction remains a severe challenge for reconstructive surgeons, which often leads to conservative treatment regimens in clinical practice, consequently resulting in poor outcomes （high morbidity and mortality）. In recent 20 years, advances in muscle flap surgery and availability of chest reconstructive prosthesis have encouraged the surgeons to take an active attitude toward chest wall resection; many ＂unresectable＂ lesions now have a chance to be resected and cured. This article reviews the problems concerning the principles for chest wall resection, reconstruction, prosthesis selection, etc. in chest wall reconstruction