Endoscopic surgery of the thoracic spine has up to now been considered as an experimental procedure. Reports published in recent years have shown that the results achieved with this technique are as good as, or for some indications superior to, those reported for classic open approaches. A review of the indications, limitations, advantages and disadvantages is presented. Although there is still resistance to acknowledging the effectiveness of this procedure, experience has shown that the results are as good, complications are fewer and postoperative recovery is improved, thus shortening the total hospitalization time.