Understanding the anatomy of the lymphatic channels and lymph nodes in the mediastinum is relevant to many disease processes as well as therapeutic interventions for thoracic malignancies. A brief review of the anatomy of the mediastinal lymph nodes is presented and the indications for mediastinal lymph node dissection are discussed, followed by a more detailed description of the technical aspects of thoracoscopic and robotic mediastinal lymph node dissection. © 2012 Elsevier Inc.