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Left-sided double lumen tubes are placed preferentially over right-sided tubes because the origin of the right upper bronchus is varied and can complicate right-sided tube placement. The left mainstem bronchus is much longer than the right (5 cm vs 1.5 cm) making placement of left-sided tubes much easier, especially for inexperienced providers. There are several indications for right-sided tubes including pathology of the left mainstem bronchus (exophytic lesions, tight stenosis, tracheobronchial disruption, endobronchial stent, or distortion by an adjacent structure/pathology) where left-sided tubes may be contraindicated or difficult to place. Right-sided tubes are also beneficial in left pneumonectomies and transplants because they allow the bronchial stump or suture line to be protected by leaving the tracheal lumen clamped until positive pressure is no longer needed. Right-sided tubes are contraindicated in anomalous take-off of the right upper bronchus above the tracheal carina (“pig bronchus”).