Image-guided thermal ablation is a minimally invasive technique that can provide local tumor control for selected lung cancers and thoracic metastases while preserving lung function. This chapter covers the principles of patient selection based on a multidisciplinary framework, a detailed breakdown of procedural techniques, and future directions. Patient selection considers the role of ablation in the management of primary lung cancer, pulmonary metastases, and pleural tumors. The technique section provides guidance regarding pre-procedural preparation, image guidance, and various ablation modalities (radiofrequency, microwave, and cryoablation), with a focus on tailoring techniques to tumor size, location, and surrounding structures.