Patients undergoing thoracoscopic surgery have severe pain, strong stress response and high incidence of postoperative depression during the perioperative period. In recent years, many kinds of drugs and methods have been used in bed to improve such problems, and s-ketamine has shown good application prospects. S-ketamine, as a new sedative and analgesic drug, has the effect of inhibiting stress response, alleviating acute pain, and reducing the occurrence of chronic pain, thereby reducing the occurrence of depression and improving the quality of rehabilitation of patients. This article reviews the progress of the application of s-ketamine in thoracoscopic surgery, providing reference for clinical application and further research.