SynopsisPulmonary metastasis can be present in as frequently as 88% and 80%, respectively, of patients with sarcoma and germ cell tumour with metastatic disease. In both sarcoma and germ cell tumour, pulmonary metastatectomy may be the only means of rendering a patient diseasefree. Sublobar (wedge or segmentectomy), lobectomy, and, rarely, pneumonectomy can be safely performed to achieve complete resection. Bilateral disease can be resected via staged thoracoscopy/thoracotomy, median sternotomy, or clamshell thoracotomy. Finally, multiple resections and re-resections in select patients have resulted in improved survival. The main principle of pulmonary metastatectomy is complete resection. In the appropriately selected patient 5-yr survival rates of as high as 35-52% for sarcoma, and 80% for germ cell tumour can be realized. -Large case series of pulmonary metastatectomy of nonseminomatous germ cell tumour (NSGCT) have reported 5-year survival rates greater than 80%.-There are no randomized trials on pulmonary metastatectomy in patients with metastatic sarcoma or NSGCT. Survival rates are from case series of selected patients without observation control arms for comparison.