Thoracic epidural anaesthesia （TEA）are practised extensively for cardiac, thoracic and abdominal surgery. However, many experimental and clinical studies have shown that TEA may have effects far beyond pain relief. TEA may decrease the neuroendocrine stress response and reduce the number of perioperative complications. Furthermore, transient thoracic sympathectomy by TEA has been suggested to offer protective cardiac, pulmonary and gastrointestinal effects as well as positive immunological and coagulation properties. The technique is thus thought to have a significant impact on the outcome of major surgical procedures. This review will focus on these non-analgetic aspects of TEA, and will discuss the most important works published recently regarding outcome studies in patients undergoing major surgery and epidural anaesthesia.