Thoracoscopic enucleation through the right thorax was successfully performed for a large leiomyoma located on the left wall of the upper-middle esophagus. Using intraoperative esophagoscopy, the exact location of the tumor was identified by trans-illumination. Two sling tapes passed around teh esophagus made the procedure as easy as that for tumor located on the right wall of the esophagus. We considered that the thoracoscopic approach through the right thorax can be applied to various types of esophageal leiomyoma, even a large one located on the left side of the esophagus.