Advances in endoscopic instrumentation and a growing enthusiasm for minimally invasive surgical techniques have sparked renewed interest in therapeutic thoracoscopy. We report the successful thoracoscopic resection of a posterior mediastinal nerve sheath tumor. A 35-year-old asymptomatic woman was found to have a posterior mediastinal mass on chest roentgenogram. Computed tomography and magnetic resonance imaging confirmed the presence of the lesion and showed no evidence of intraspinal extension. Exploratory thoracoscopy revealed a localized lesion without intraspinal extension. Thoracoscopic resection of the lesion was then performed. The patient's postoperative course was uncomplicated and she was discharged on the fifth postoperative day. The therapeutic potential of thoracoscopy continues to be realized as experience with the technique grows.