 Interoperative lung ultrasound, ILU, is a new ultrasound technique used for lung surface assessment during video-assisted thoracoscopic surgery procedures. This technique was developed based on ultrasound's basic physical principles for image generation and interpretation. Compared with transasophageal ultrasound, TUS, ILU provides better visualization of the lung surface and can be used to detect more subtle pathologies. However, most of the TUS-artifact-based diagnostic algorithms should be reappraised when using ILU. This article was authored by Marco Sperindeo, Julia Gaudioso, Carla Maria Irene Curado, and others.