In the surgical treatment of autoimmune myasthenia, complete thymectomy is considered indispensable to ensure maximum clinical results. From May 1995 through June 1997, we carried out video-assisted extended thymectomy via sole left access in 16 patients. There were no deaths and no major complications. At the intermediate-term follow-up, remission and improvement rates were 19% and 56% respectively. These results were similar to those achieved on the last 16 patients who had extended thymectomy via median sternotomy. We believe that the advantages of the video-assisted approach render it a reliable option for the surgical management of autoimmune myasthenia.