Myasthenia gravis (MG) is an autoimmune disease caused by dysfunction of transmission at the neuromuscular junction. The human immune organ, the thymus, is closely related to the pathogenesis of the disease. Since Blalock et al. reported in 1944 that 20 patients with MG who underwent transthoracic thymectomy could effectively delay symptoms, thymectomy has become the primary option for the comprehensive treatment of MG. Nevertheless, there are no prospective clinical studies to confirm whether drug therapy alone (prednisone, etc.) is better than thymectomy in improving patients’ muscle strength to improve their quality of life. In addition, patient selection, surgical approach, and scope of thymectomy have been the subject of debate, and there is no universally accepted classification, grading system, or method of evaluating efficacy. Therefore, physicians should carefully consider the following three points before deciding to perform thymectomy: (1) Open surgery: transthoracic thymectomy; transthoracic maxillary thymectomy; transcervical maxillary thymectomy. (2) Minimally invasive surgery: transcervical thymectomy; thoracoscopic (VATS) thymectomy. Studies have found that there are advantages and disadvantages to each surgical approach to surgical treatment. Clinical studies with large sample sizes have shown that minimally invasive thymectomy has fewer complications, shorter hospital stays, and less pain compared to open thoracotomy. Minimally invasive surgery provides maximum protection of lung function and meets the cosmetic needs of younger patients with incisions. In addition, with the increasing standardization of robotic surgical procedures, robotic thymectomy will also be fully put into the minimally invasive treatment of MG. The MG Foundation of America (MGFA) introduced the MG Classification and Staging System in 2000, which can be used to assess the progression and remission of MG before and after treatment. Dr. Marulli recently integrated complete stable remission (CSR) data for patients undergoing VATS and robotic thymectomy and showed that 28%-42.8% of VATS thymectomy patients and 27%-42% of robotic thymectomy patients achieve CSR. These different clinical outcomes are due to a number of differences that make the objective evaluation of clinical outcomes after thymectomy more difficult. These differences include: (1) differences in follow-up time; (2) differences in the extent of disease (including the presence or absence of thymoma, ocular and generalized muscle weakness classification, and time to onset of preoperative symptoms); (3) differences in physician evaluation criteria for recovery status; and (4) differences in postoperative medication strategy and dose. 3. Postoperative medication reduction Considering postoperative medication reduction, postoperative medication can be reduced or even suspended after thymectomy. However, few studies have reported and valued this view. The authors believe that reducing drug dependence is the greatest benefit of thymectomy for MG patients for two reasons: (1) it avoids adverse drug reactions and reduces the side effects of immunosuppressive therapy (tumors, infections, etc.). (2) The thymectomy can reduce the financial burden of drug therapy for patients who are on long-term medication for immunosuppressive therapy. The complexity of MG classification and staging makes it difficult to conduct prospective clinical studies. In order to have a clearer understanding of the clinical effects of surgical treatment, combined medical-surgical treatment, and medical treatment on MG, future studies should apply the MG classification and staging system developed by MGFA as much as possible in order to more objectively evaluate the advantages and disadvantages of different treatment strategies.