Fifty-five patients with 72 thoracic disc herniations were retrospectively reviewed in an effort to ascertain the natural history of this disease. The treatment programs given to these patients were evaluated, and 15 (27%) of the 55 patients eventually required surgery. The majority, however, did not require surgery and have continued to perform activities of daily living, some even participating in vigorous sports activities (eg, skiing) without any apparent neurologic consequences. Thoracic disc herniations, similar to cervical and lumbar disc herniations, do not always lead to major neurologic compromise. A less aggressive surgical approach therefore can be considered.