Young spontaneous pneumothorax is mostly associated with rupture of pulmonary blisters. Compared with older pneumothorax patients, young pneumothorax patients have a limited number of lesions and high requirements for postoperative quality of life, so the choice of treatment should focus on radical treatment and avoid recurrence. At present, the treatment for pneumothorax is divided into two categories, thoracentesis or closed chest drainage is a conservative treatment, which is easily accepted by patients, but it is easy to recur because of untreated pulmonary herpes lesions, and after repeated pneumothorax, ectopic adhesions are easily formed in the chest cavity, which increases the chance of hemopneumothorax, and also affects good lung reopening and pulmonary function. Thoracoscopic surgery to remove pulmonary blisters with simultaneous pleural fixation (by pleural friction) is a radical treatment, which is more effective in preventing recurrence, while minimally invasive means enable patients to recover early, and is the best choice for young patients with spontaneous pneumothorax. Active surgical treatment is currently advocated for the following types of patients: recurrent pneumothorax, bilateral pneumothorax, hemopneumothorax, occupational needs (e.g., divers, long-term field workers, long-term travelers), and imaging suggestive of the presence of definite pulmonary maculopathy.