Thoracic abscesses and empyema present significant challenges in both surgical and anesthetic management due to their complex pathophysiology and the critical state of patients. This review focuses on the anesthetic considerations and strategies employed in the management of these conditions. The complexity of these cases necessitates a tailored anesthetic plan, incorporating advanced airway management, optimal fluid management, and vigilant intraoperative monitoring to ensure the best possible outcomes. Effective anesthetic management requires a multidisciplinary approach that includes preoperative assessment, intraoperative management, and postoperative care