Since the introduction of video‐imaging and endoscopic surgical interventions, there is a worldwide renewed interest in thoracoscopy. However, thoracoscopy for diagnosis of pleural and pulmonary disease has been performed for more than 30 years. An overview is presented here of the results and experiences in the past 3 decades of thoracoscopy for diagnosis of pulmonary and pleural disease. Thoracoscopy is a simple and safe method to obtain a diagnosis in case of pleural effusion, pleural mass, or interstitial lung disease. In most cases, it can be performed under local anaesthesia.