Thoracoscopic resection of a mediastinal tumor or cyst was done in three patients: two with neurogenic tumors and one with a bronchogenic cyst. The tumors and cyst showed evidence of a discrete plane on computed tomography of the chest. The mean operation time and estimated blood loss were 156 min and 45 g, respectively. For all three patients, the chest drain was removed within 48 h after operation, and there were no complications related to thoracoscopic surgery. The advantages of this approach are less pain, early return to normal activity, and an acceptable cosmetic appearance. Based on our experience, thoracoscopic surgery is considered the treatment of choice for certain mediastinal tumors or cyst.