Anaesthesia for Robot assisted thoracic surgery incorporates the complexity of one lung anaesthesia with that of perioperative concerns associated with the surgical robot. Minimally invasive thoracic surgeries (MITS) include Video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS). Since the first report of use of surgical robot in thoracic surgery in 2001 in Pisa (Italy) (Eur J Cardiothorac Surg. 21(5):864–8, 2002), the technique has evolved and today lung resection, mediastinal tumour resection, diaphragmatic repair, esophagectomy are performed on a regular basis by RATS. Although robotic assistance has certain advantages for the surgeon and also positively affects patient outcome, it definitely adds intraoperative challenges for the anaesthesiologist. Prominent amongst them are restricted patient access, prolonged and extreme positioning induced injuries, risk of trauma by robotic arms, bystander injury of internal organs, capnothorax induced cardiorespiratory effects, long set up time and duration of one lung anaesthesia especially while in the initial learning curve. In this chapter, anaesthetic management of RATS is comprehensively described starting from patient preparation till post-operative management.