Video-assisted thymectomy and its variations is not generally accepted approach in surgical treatment of myasthenia gravis yet. Authors present their initial experience with videothoracoscopic technique in surgery for thymic cysts and myasthenia gravis. Authors prefer left thoracoscopic approach which allows good view to the thymus in mediastinum and neck. Recent studies confirm generally known advantages of miniinvasive surgery and show no differences between open and thoracoscopic thymectomy in terms of treatment outcome of myasthenia gravis. Nevertheless, prospective randomized study comparing open and thoracoscopic thymectomy in myasthenia gravis is not known.