The surgical technique to achieve complete resection for superior sulcus tumor invading major anatomical sites including the subclavian vessels is challenging. The anterior transcervical-thoracic approach applied by Dartevelle and colleagues provides excellent exposure of the subclavian vessels. Grunenwald and associates have improved on this approach to preserve the clavicle and sternoclavicular joint. This paper describes the merits of this approach and details how to perform this surgical procedure.