The double‑lumen tube (DLT) is a critical tool for isolating both lungs and enabling single-lung ventilation during thoracoscopic and mediastinal surgeries. It offers advantages such as avoiding mediastinal swing, preventing secretion inflow to the healthy lung, and facilitating surgical procedures, making it widely used in anesthesia for thoracic surgery. To address issues related to DLT size mismatch and suboptimal positioning during intubation, anesthesiologists have proposed various strategies to improve intubation success rates. These include evaluating bronchial size through preoperative examinations and selecting the appropriate DLT, along with employing various enhanced intubation techniques and tools. This review summarizes methods for assessing the airway related to DLT intubation using CT, X‑ray, ultrasound, and 3D printing, as well as discussing potential intubation techniques and visualization tools. The goal is to provide anesthesiologists with more options for DLT intubation, reduce the incidence of DLT malpositioning, and facilitate the improvement and development of DLT's clinical applications.