The authors' surgical procedure for the treatment of symptomatic thoracic disc herniation has consisted of total discectomy of the involved intervertebral disc, followed by intervertebral body fusion using autogenous iliac bone through an anterior approach. The authors prefer the extrapleural approach to the thoracic vertebrae because of simplified postoperative care with minimum surgical interference with respiratory function. During the past 16 years, 23 patients with symptomatic thoracic disc herniation have been treated by this procedure. Preoperatively all 23 patients presented with some measure of paraplegia, with difficulty in walking. Their clinical presentation was analyzed and diagnostic aids to the thoracic disc herniation by radiographic examinations were assessed. The radiographic abnormality of ossification of the yellow ligament (OYL) coinciding with the involved thoracic disc level was noted. The results in all 23 patients with this procedure were favorable. Based on the results of this series, this procedure is recommended for the treatment of symptomatic thoracic disc herniation.