Cardiothoracic surgery has progressed from an era of limited visualization and high-risk exploratory procedures to a digitally integrated discipline shaped by advanced imaging, computational modeling, and intelligent intraoperative guidance. This chapter traces that evolution from early landmark innovations, such as the introduction of echocardiography, cardiopulmonary bypass, and minimally invasive techniques, to the rapid emergence of artificial intelligence (AI), augmented reality (AR), and robotics as central pillars of modern surgical care. Across thoracic oncology, coronary revascularization, aortic intervention, and mitral valve repair, AI now enables automated anatomical segmentation, disease characterization, hemodynamic simulation, and predictive analytics that enhance decision-making beyond traditional imaging and clinical scoring systems. AR technologies further bridge preoperative planning and intraoperative execution by projecting patient-specific 3D models and navigational cues into the surgical field, improving anatomical orientation and precision in both minimally invasive and robotic approaches. Coupled with advances in computational fluid dynamics, image fusion, and digital-twin modeling, these tools are transforming surgical workflows into data-driven ecosystems where virtual rehearsal, real-time guidance, and quantitative outcome prediction converge. As ethical and regulatory considerations gain prominence, the integration of human expertise with intelligent, adaptive systems is reshaping cardiothoracic surgery into a more precise, personalized, and anticipatory specialty, one in which surgeons increasingly operate with computational insight, enhanced visualization, and unprecedented procedural support.