Thoracoscopic surgery has expanded with advances in endoscopic surgical instrumentation. We report on a 21-year-old woman with a complete thoracoscopic resection of an intercostal neurilemoma, which occurred extrapleurally in the ninth intercostal space of the lateral thoracic wall. The tumor was 70 x 40 x 25 mm in size, but a thoracotomy with a rib resection was avoided. The patient had an uncomplicated postoperative course and was discharged on the fourth postoperative day. Thoracoscopic resection of an intercostal neurilemoma, presenting as a lateral chest wall tumor, may be a safe and useful approach with an improved cosmetic result.