Thoracoscopy would seem to have several potential advantages over open techniques in terms of the attendant postoperative pain and pulmonary complications. Although many questions exist pertaining to the use of thoracoscopy in the therapeutic management of malignancies of the mediastinum, its use for benign disorders appears desirable. Since December 1990, we have removed 9 mediastinal cysts using a thoracoscopic procedure. These included 7 bronchogenic or enteric cysts, 1 pericardial cyst, and 1 thymic cyst. The average cyst size was 4.2 cm, with 11 cm the largest diameter. Complete removal of the cysts was possible in all but 1 case, in which the cyst adhered to vital structures. A portion of the cyst wall was therefore left intact and the mucosa cauterized. The average hospital stay in these patients was 2.1 days, and there were no intraoperative or postoperative complications. All cysts were benign. The resection of mediastinal cyst using thoracoscopic procedures and based on standard surgical indications would seem to be appropriate. Thoracoscopic removal should be considered as an alternative method to resection of mediastinal cysts.