The authors present surgical treatment of a 52-year-old female patient diagnosed with giant left atrial appendage aneurysm (LAAA) after examination for paroxysmal atrial fibrillation. Thoracoscopic resection of LAAA without cardiopulmonary bypass and epicardial radiofrequency isolation of pulmonary vein collectors and posterior wall of the left atrium (“box lesion set”) were performed. There were no postoperative complications and rhythm disturbances. The patient was discharged after 5 days.