The success rate of thoracoscopic resection of parenchymal blebs in spontaneous pneumothorax was evaluated after 54 thoracoscopies (cases) in 52 patients. Switch to open thoracotomy was necessitated by interpleural adhesions or large bullae in five cases, while 49 were treated thoracoscopically. The median duration of the operation was 75 (25-240) min, and the postoperative hospital stay was 7 (3-25) days. Early postoperative complications were haemothorax and recurrence of pneumothorax, each in one case, treated with thoracoscopy and chest drain, respectively. Forty-six patients were followed up for a median of 11 (1-32) months. there were two recurrences (at 4 and 6 months). One was successfully treated with thoracoscopy and the other with thoracotomy. Only five patients complained of slight sensitivity in the scar area, caused by weather changes. Thoracoscopic bleb resection is an effective alternative to thoracotomy, with low rates of complications and recurrent pneumothorax.