We reviewed our experience with video-mediastinoscopy as an outpatient procedure. From November 2002 to May 2003, 20 video-mediastinoscopies were performed on an out-patient basis. There were no operative deaths. No surgical complication is reported in a patient requiring readmission and antibiotic therapy for left pneumonia. In conclusion, video-mediastinoscopy can be safely performed on an out-patient basis in selected patients with mediastinal involvement.