Thoracoscopic surgery has grown from simple to complex in procedure, and has been more widely accepted in merely 20 years since first started. Now it has become a standard technique in chest surgery. This includes lung surgery of wedge resection, anatomical lobectomy, segmentectomy and even pneumonectomy, mediastinal surgery of tumor resection or thymectomy, and more. Relatively early stage lung cancer is also becoming a good target. Compared with conventional open thoracotomy, thoracoscopic surgery is superior in minimal invasiveness and outcomes to open thoracotomy in spite of inconvenience in skills. These two are not competitive but complement each other, and their future will be promising.