Surgery alone or in combination with adjuvant therapies provides the best possibility for cure for non-small cell lung cancer patients with local disease. The most common surgical resection is lobectomy. In addition, the local and mediastinal lymph nodes are removed for disease staging and adjuvant therapy evaluation. Thoracoscopic surgery is performed through small incisions. The surgical and oncological principles are identical but the benefits of the thoracoscopic approach include faster recovery and extension of curative resection to patients not tolerating thoracotomy. Thoracoscopic lobectomy seems to be comparable to open surgery with respect to the local cancer recurrence and long term survival.