The patient, a male, had a small right eye fissure and blurred vision for 1 month. A chest CT revealed a left anterior mediastinal thymoma, which was preoperatively diagnosed as thymoma with oculomotor type myasthenia gravis, and a thoracoscopic thyme and anterior mediastinal lipectomy was performed, which was postoperatively confirmed as AB thymoma. After the operation, the patient’s eye fissure returned to normal and the blurred vision was corrected. Thoracoscopic surgery for thymoma with myasthenia gravis avoids sternal splitting, is less traumatic, has quick recovery, has good results, and meets cosmetic requirements.