The relevance of endobronchial ultrasonography (EBUS) to thoracic surgeons is 2-fold: first, EBUS is an accurate and versatile diagnostic tool; second, EBUS is of importance to our specialty.The diagnostic performance of endobronchial ultrasonography (EBUS) is similar to that of mediastinoscopy, except for a lower negative predictive value for EBUS. Consequently, EBUS does not replace mediastinoscopy, but instead EBUS and mediastinoscopy are complementary. A thoracic surgeon proficient in EBUS has the ability to decide which tool or combination of tools to use to optimize patient care. The relevance of EBUS can be described in evolutionary terms: proficiency in EBUS exemplifies a new trait that can enhance our adaptability to the current environment. An indirect measure of the acquisition of this new skill by our specialty can be gleaned from an overview of original EBUS publications: nearly one-half are authored or coauthored by thoracic surgeons. EBUS is an excellent diagnostic tool available to thoracic surgeons to optimize patient care and an example of a skill that may enhance our survival as a surgical specialty.