The treatment of spontaneous pneumothorax aims to eliminate symptoms, promote lung reopening and prevent recurrence of pneumothorax. A small amount of pneumothorax (lung compression <30%) can be closely observed and regularly reviewed, and the gas will usually be gradually absorbed. For small to moderate amount of pneumothorax, thoracentesis can be performed. A syringe is used to extract the gas from the pleural cavity to alleviate symptoms and promote lung reopening. Closed thoracic drainage is a more effective method for treating pneumothorax. Generally, a closed chest drainage tube is placed in the 2nd intercostal space in the midclavicular line and connected to a water seal bottle. In most patients, the air leakage stops within 48 hours, and the closed chest drainage tube can be removed after the review of chest X-ray without pneumothorax. If spontaneous pneumothorax is not treated surgically, the recurrence rate after the first attack is about 50%, and the recurrence rate after the second attack is about 80%. Neither thoracentesis nor closed drainage is effective in preventing recurrence of pneumothorax, while surgical treatment is the most effective means to prevent recurrence of pneumothorax. The recurrence rate after surgical treatment is less than 1%. Surgery includes resection of pneumomediastinum and pleural fixation. The indications for surgery are: 72 hours after the first episode of closed chest drainage the lungs still cannot be reopened; bilateral pneumothorax; tension pneumothorax; hemopneumothorax; recurrence of pneumothorax (including ipsilateral recurrence and contralateral occurrence of pneumothorax); patients with special occupations, such as divers, pilots, etc. In recent years, television thoracoscopy (VATS) has been gradually and widely used in the treatment of pneumothorax. Pneumothorax is removed through thoracoscopy using an endoscopic sutured incisor with a small amount of normal lung tissue around it, and a dry gauze ball is used to rub the wall pleura to fix the pleura. Compared with traditional surgery, thoracoscopic surgery has the advantages of small incision, less trauma, less pain, faster recovery and shorter hospital stay, making it the preferred surgical treatment for spontaneous pneumothorax.