The aim — compare the results of thymectomies performed through videothoracoscopic access and sternotomy access. To study the level of safety, efficiency and feasibility videothoracoscopic operation Material and methods. The results of 71 thymectomies performed in patients with tumors and myasthenia gravis were studied. In study group in 28 patients underwent videothoracoscopic thymectomy, in 42 patients in control group was carried out through sternotomy access. Results. The results demonstrated that the use of videothoracoscopic access does not affect on the average duration of operative intervention (119.4±41.8 min vs.127.6±52.3 min; p>0.05), but statistically significantly reduced intraoperative blood loss (94.7±77.4 ml vs. 163.5±133.2 ml; p<0.05), postoperative parenteral analgesia (2.3±0.8 days vs. 3.1±1.1 days; p<0.05), and the average duration of hospitalization (8.4±3.6 days versus 11.6±4.9 days; p<0.05). The incidence of complications is not demonstrated statistically significant differences between groups, although after a videotрoracoscopic operation, it was found to be substantially lower (10.7% vs. 18.6%; p>0.05). Conclusion. Thymectomy by videothoracoscopic access is a feasible, effective and safe operational intervention in patients with myasthenia gravis and/or tumors of the thymus, not having signs of macroscopic invasion of the capsule.