Normally, there is no gas in the pleural cavity, i.e., between the lung and the chest wall, and only a small amount of fluid lubrication. If gas appears in the pleural cavity without a clear trigger (e.g., trauma, invasive operation, etc.), it is called spontaneous pneumothorax. The typical presentation is sudden onset of chest pain and shortness of breath, which may be accompanied by coughing. The severity of symptoms is related to the amount of pneumothorax and to the presence or absence of concomitant diseases. The most common examination methods are X-ray frontal and lateral chest radiographs and chest CT scans, which can determine the extent and degree of pneumothorax and the presence of concomitant diseases. The treatment principle depends on the degree of pneumothorax, concomitant diseases and whether it is recurrent. Generally speaking, for <30% of pneumothorax, needle aspiration or fine catheter aspiration can be performed, while those with more than this degree or with COPD, asthma and other diseases, closed chest drainage should be performed. Patients whose pneumothorax does not remit after the above treatment, or whose pneumothorax recurs after remission (the first recurrence rate of primary spontaneous pneumothorax reaches 50%, while the second recurrence rate after one recurrence reaches 80%) need to be treated surgically. The traditional open-heart surgery with alveolar ligation and pleural stripping is very damaging and not easily accepted by the majority of young and middle-aged patients, especially for young female patients. The Department of Thoracic Surgery of Xuanwu Hospital of Capital Medical University is the first one to carry out TV thoracoscopic surgery for spontaneous pneumothorax in China, which only requires 2-3 incisions of about 2cm on the chest wall and the thoracoscopic instruments are inserted into the chest cavity under the surveillance of the camera to complete the same operation as the traditional open chest surgery. Because of the small incision, the aesthetics is almost unaffected and the efficacy is very certain, it is the preferred method for the treatment of spontaneous pneumothorax in the field of thoracic surgery at home and abroad.