Morelli and Di Paola's thoracotomy allows to approach the pleural space with the only osteo-muscular sparing without any section of chest wall structures. With this kind of approach that we have been employing since twenty years, we report our experience about 82 cases recently operated on for both pulmonary and mediastinal disease. Unlike who don't consider this approach to allow adequate exposure of all endothoracic anatomic structures, it is our opinion that this thoracotomy not only allows every kind of operation in thoracic surgery, but is easy to perform and fast to repair. Moreover, postoperative pain is decreased, functional recovery is improved and patient can frequently be discharged earlier from the hospital with a very satisfactory aesthetic result.