In the period between May and October 1992 we have admitted in our department 14 patients (M/F: 11/3) with recurrent spontaneous pneumothorax, being the entity more than 40% in 8 of them. All the patients were treated with video-assisted thoracoscopic pleurectomy, beginning from the 2nd to the 6th rib, completing by abrasing the further ribs below. Whenever the causative bullae or blebs were found, those were resect using and endoGIA. At the end of the procedure a pleural drain (no. 24) was positioned and maintained on suction until a complete lung reexpansion was ensured for at least a couple of days. Neither postoperative nor delayed complications and no recurrences have been observed. Our results of such an approach, once indicated the pleurodesis for the treatment of spontaneous pneumothorax, are undoubtedly encouraging both for the technical simplicity and the reduction in hospitalization time.