This case describes a postoperative complication after single-lung ventilation in a 10-year-old patient scheduled for scoliosis repair. This patient underwent an anterior thoracoscopic excision of several vertebral discs followed by a posterior double-rod fixation of her spine. The postoperative course was complicated by complete atelectasis of the patient's right lung for 5 days. Methods of single-lung ventilation, advantages and disadvantages of the Univent® tube versus the double-lumen tube, and the possible mechanisms leading to postoperative atelectasis in this child are discussed. © 2003 by Elsevier Science Inc.