Thoracoscopic excision of an esophageal leiomyoma was successfully performed in 5 patients. The tumours were enucleated easily without intraoperative complications. A patient in whom the muscular layer was not sutured after removal of the myoma, one year after the operation presented an esophageal pseudodiverticulum requiring a thoracotomy for resection. This new procedure which reduces the operative trauma and postoperative pain and allows quick recovery is described.