The video-assisted thoracoscopic approach has become a useful adjunct in the treatment of scoliosis. This minimally invasive anterior approach allows access to the thoracic spine, providing a means of achieving disk excision and anterior body fusion. The advantage of this technique is the limited chest wall dissection required to reach the anterior thoracic spine. More recently, techniques have been developed to allow anterior instrumentation for an entirely endoscopic method of performing scoliosis correction. This approach is appropriate for curves less than 70 degrees when only the thoracic curve is structural. The outcomes of this approach are promising and suggest reduced morbidity compared with open anterior approaches.