Using video thoracoscopic techniques in 30 patients over a twelve month period we have been able to perform 33 procedures that would have been previously performed by thoracotomy, with its associated morbidity. We have found the applications of this procedure to be diverse, being both diagnostic (n = 16) and therapeutic (n = 17). The diagnostic procedures were associated with a high diagnostic yield and allowed accurate staging. The therapeutic procedures were associated with minimal morbidity and short hospital stay. Our experience indicates an established and expanding role for Video Assisted Thoracic Surgery.