Video-assisted thoracic surgery (VATS) procedures have been adopted widely and rapidly for the treatment of a wide range of benign and malignant thoracic disorders. To date, there is only incomplete information available about the complications associated with these techniques. In this article, the available literature addressing the types and incidence of postoperative complications associated with VATS procedures is reviewed, as are the problems of incisional pain, alterations in respiratory function, and dissemination of malignancy following manipulation of tumors by VATS techniques.