The authors review the literature concerning post-sternotomy mediastinitis. The incidence, mortality, diagnosis and risk factors are discussed, but above all, the various treatments are reviewed and compared with respect to their advantages and risks, their respective usefulness and results, in order to define a reasonable way of management of this highly pejorative surgical complication. Open technique, closed irrigation and surgical flaps of omentum, pectoralis major and rectus abdominis are successively considered.