This study was undertaken to determine whether a complete lung cancer operation can be done by video-assisted thoracic surgery and to evaluate the postoperative course. Forty-five patients (44 to 82 years of age) with clinical stage 1 lung cancer underwent video-assisted thoracic surgery for lobectomy or pneumonectomy with mediastinal lymph node sampling or dissection. There were no deaths or major complications. The median hospital length of stay was 4 days. Six patients stayed in the hospital for more than 7 days for pneumonia (n = 1), air leak (n = 3), or serous drainage (n = 2). Five of the seven patients who were 80 to 82 years of age were discharged by the fourth postoperative day.