Objective] To investigate the method, feasibility and safety of thoracoscopic resection of esophageal smooth muscle tumor. [Methods] From September 2005 to October 2008, 8 cases of esophageal smooth muscle tumor resection were performed by thoracoscopy in our hospital. All of them were diagnosed with esophageal smooth muscle tumor by gastroscopy, upper gastrointestinal barium meal radiography and chest CT before operation. [Results] All patients were operated under thoracoscopy, and there were no patients who were transferred to open chest. The operation time was 80~135min (110±24)min, intraoperative bleeding was 30~90ml (62±18) ml. No surgical death and postoperative serious complications occurred, and all patients were discharged from the hospital. The duration of hospitalization was 5~10 days (7.3±2.6). Postoperative pathological diagnosis was confirmed as esophageal smooth muscle tumor in all cases. Follow-up was 4~43 months (28±15) without recurrence. [Conclusion] With the proficiency of thoracoscopic surgical operation techniques, thoracoscopic esophageal smooth muscle tumor resection is a safe, effective and reliable minimally invasive procedure.