Despite the low comparative incidence, thymic tumors are the most common primary tumors of the anterior mediastinum. Although their biological behavior is relatively good and hematogenous and lymphatic metastases are rare, thymic tumors are considered malignant once they grow to a certain extent and break through the pleura and large pericardial vessels, causing dissemination of the pleural cavity or involvement of large vessels. Moreover, in recent years, I have found that the incidence of thymoma is grossly underestimated, and an important reason for this is the widespread use of CT in clinical practice, including those found unintentionally during physical examinations and also during other examinations such as coronary CT. Minimally invasive treatment is an important direction. In the last decade, the development of thoracic surgery technology has been rapid, especially the advancement of minimally invasive treatment has completely overturned the past understanding of thoracic surgery. The thymus is located in the anterior mediastinum, and the gap behind the sternum is very narrow. The development of minimally invasive treatment in thymic diseases is controversial, and surgeons have concerns about vascular damage and phrenic nerve injury, as well as the lack of radical tumor resection. At present, the basic consensus is that for clinical stage I and II thymoma, minimally invasive treatment can replace the median sternotomy in the past. The 2014 NCCN guidelines for the treatment of thymic tumors also mention this point, that minimally invasive treatment of thymic tumors should be carried out with caution, and that skilled surgeons can carry out this technique in some large medical centers. My own view is the basic principles that need to be followed in surgery: 1. safety of the procedure; 2. oncologic principles; and 3. minimally invasive treatment. This order of consideration is what surgeons should adhere to.