Surgery remains the cornerstone of therapy for thymoma whether the lesion is encapsulated or invasive. Video-assisted thoracic surgical techniques may be applicable in a number of patients with encapsulated thymoma for definitive therapy, especially when combined with a transcervical approach to achieve total thymectomy. Initial experience with a minimally invasive approach for resection of thymomas is described. The development of new instrumentation facilitates the performance of these procedures.