Thoracoscopic surgery (VATS) has now become another major technical revolution in thoracic surgery since the advent of extracorporeal circulation technology, and the application of VATS has become the accepted surgical method of choice for some common thoracic diseases such as spontaneous pneumothorax, mediastinal tumors, and hand sweats. While for pulmonary nodules there was once controversy, its advantages are now internationally recognized. VATS has unparalleled advantages in the diagnosis and treatment of pulmonary nodules. Firstly, in terms of diagnosis: 1, for nodules less than 1 cm in diameter, puncture biopsy is difficult (it is not easy to puncture the nodules or too little tissue is obtained) and there is a certain degree of false negativity (pathology reports benign tumors but cannot exclude the possibility of malignant lesions), while pathology after thoracoscopic nodule excision can clearly diagnose and achieve the purpose of treatment. 2. For bilateral multiple nodes, sometimes metastasis is suspected and difficult to be detected by puncture biopsy, only pathology after thoracoscopic node excision can make a clear diagnosis. The diagnosis of metastasis based on experience alone is wrong, and sometimes it can seriously affect the choice of treatment plan or even delay the treatment. In terms of treatment: the probability of malignant lesions in pulmonary nodules with a diameter of 2-3 cm is increasing, so VATS can be performed to clarify the pathology while performing radical tumor surgery (currently an internationally recognized safe and effective procedure). In summary, VATS is particularly suitable for pulmonary nodules located in the periphery of the lung that cannot be confirmed by cytology and fibrinoscopy, preferably in the following conditions: 1) non-calcified nodules less than 3 cm in diameter; 2) single pulmonary nodules that cannot be characterized by conventional examination; 3) lesions located in the peripheral third of the lung; 4) no endobronchial dissemination. Intraoperatively, lesions >1 cm can be localized by direct intraoperative observation, instrumentation or direct palpation by hand; whereas lesions <1 cm are preferable to be localized by preoperative CT-guided fine-needle aspiration.