OBJECTIVES: To estimate economic burden of Air Leak Complications (ALC) in patients undergoing thoracic surgery.    METHODS: The Premier Perspective® Database containing billing data from over 600 hospitals in the U.S was used to meet the study objectives. All elective primary lobectomy, segmentectomy, and wedge resections from 2012-2014 were identified. During the hospitalization, ALC were identified as a composite of air leak and pneumothorax ICD-9 diagnosis codes. Generalized Estimating Equations (GEE) models were used to estimate impact of ALC on Length of Stay (LOS), Operating Room Time (ORT) and hospital costs after controlling for patient, procedure, and hospital factors.  The multivariable models were run on the overall sample and by resection types.  GEE accounted for the clustering of patients within hospitals; p values of <0.05 were considered to be statistically significant.  RESULTS: A total of 21,150 patients undergoing thoracic surgery were included in the analysis: lobectomy (n=10,946), segmentectomy (n=1,788), and wedge (n=8,416). The overall incidence of ALC was 24.26% and varied with resection type (lobectomy=29.20%; segmentectomy=22.04%; and wedge 18.30%). The mean LOS for thoracic surgeries in the sample was 5.7 days (SD=5.4), with an average ORT of 211 mins (SD=190) and overall hospital costs of $22,163 (SD=$83,619).  Results of the GEE models indicated that patients with ALC during their thoracic surgery had a significantly higher economic burden [Adjusted Means, Standard Error of Mean (SE): LOS=7.24 (SE=0.12) days; ORT=214.9 (SE=6.4) mins; and hospital costs=$26070 (SE=1404)] compared to those without ALC [Adjusted Means, SE: LOS=4.75 (SE=0.07) days; ORT=201.7 (SE=3.9) mins; and hospital costs=$19,558 (SE=399)]. The incremental economic burden of ALC was consistently significant across all resection types. CONCLUSIONS: This analysis shows that Air Leak Complications in patients undergoing thoracic surgery are not only frequent but also associated with significantly higher resource utilization in terms of LOS, ORT and hospital costs.