Objective: To review the experience of videoassisted thoracoscopic surgery for the treatment of primary spontaneous pneumothorax. Patients and intervention: One hundred and eighthteen consecutive patients undergoing thoracoscopy for primary spontaneous pneumothorax from January 2007 to July 2013. Results: The mean age of the patients was 28.2 years (range, 16 to 55 years), and 102 were men (86.4 percent). All patients were successfully treated using video-assisted thoracoscopic technique. Recurrent pneumothorax was the most frequent indication for surgery, occurring in 83 patients. The most common method of management was stapling of an identified bleb, which was done in 71 cases. Pleurodesis was achieved by gauze abrasion (n = 79) and apical pleurectomy (n = 39). Postoperative prolonged air leak occurred in five patients (4.2 percent). There were no deaths attributable to the procedure. The mean ( percent SD) postoperative pleural drainage was 3.1 percent 2.8 days. Conclusions: Video-assisted thoracoscopic surgery is a safe procedure in the treatment of primary spontaneous pneumothorax. Pleurodesis was achieved by abrasion is a more safe and effective way of producing apical pleurectomy.