Four cases of pleuropericardial cyst (three symptomatic, one in an unusual location) were treated by videothoracoscopy. Complete resection of the cyst was possible in all cases. The postoperative course was uneventful and patients were discharged on the 4th or 5th day. Pleuropericardial cysts account for 5 to 10% of all mediastinal tumors. Clinical latency and a benign course are characteristic features. In most cases, computed tomography (CT) confirms the diagnosis. When the cyst is symptomatic or the diagnosis is in doubt (atypical location, high density on CT scans), videothoracoscopy offers an alternative to transpleural puncture with evacuation or excision via thoracotomy.