Mediastinal tumors are uncommon and often asymptomatic if benign. Tumors have a predilection for arising in one of three mediastinal compartments; anterior, middle, or posterior. If symptoms are present, they are usually compressive in origin. Computed tomography is almost always the imaging modality of choice. Benign-appearing lesions are usually resected for cure. Malignant-appearing lesions usually require biopsy by the least invasive route appropriate for the suspected tumor type.