Videothoracoscopy and video-assisted thoracic surgery are by now already standard therapeutic procedures in thoracic surgery. The authors submit their experience with the method after 300 thoracoscopic operation at the surgical clinic of the Faculty Hospital in Plzen from the end of 1993 to the beginning of 2000. The main indications for this mini-invasive procedure is the treatment of spontaneous pneumothorax, diagnostic biopsy in pulmonary dissemination of obscure etiology, diagnosis and treatment of pleural exudates and elimination of minor peripheral pulmonary lesions. The authors discuss different surgical procedures in the most frequent diagnoses, their advantages and risks, indication criteria, complications. Attention is also paid to the causes of 10% conversions. In case of treatment of a spontaneous pneumothorax the authors consider videothoracoscopy as the method of first choice, while in case of primary carcinoma of the lungs they recommend the classical procedure. Other possibilities for the wider application of thoracoscopy and its development in their own department include in particular traumatic thoracic surgery.