Chest wall defects generally result from resection of primary chest wall tumors, locally-invasive malignancies, or metastatic lesions. After an R0 chest wall resection, first skeletal stability must be established with prosthetic or bioprosthetic materials, or a combination of both. Regardless of the technique used to establish skeletal stability, soft tissue coverage of the prosthesis is necessary. The primary goals of all chest wall reconstructions are to obliterate dead space, restore chest wall rigidity, preserve pulmonary mechanic, protect intrathoracic organs and provide soft tissue coverage. In this article, our aim is to review the basic principles and indications of the chest wall resection and reconstruction, preoperative evaluation of patients, and the materials and methods used for the reconstruction.