Video-assisted thoracoscopic surgery (VATS) has emerged as a minimally invasive therapy of intrathoracic neurogenic tumors, when the diseases occur in the adult and show no intraspinal extension. We have reviewed five cases: three tumors arose from the sympathetic chain with no intraspinal extension, vagus nerve in one, and intercostal nerve in one. For all five patients, hospitalization was brief, recovery was relatively rapid, and long-term results were excellent. We believe that when the indication for the treatment of patients with an intrathoracic neurogenic tumor are met in the adult, the procedure of choice should be the VATS approach.