[Abstract] Objective To summarize the long-term efficacy of thoracoscopic thymectomy for the treatment of myasthenia gravis and to analyze the potential impact of combined thymoma on the surgical efficacy. Methods A retrospective study was conducted on 47 patients with myasthenia gravis who underwent thoracoscopic surgery from April 2001 to October 2009 at the Peking University People’s Hospital. Patients were divided into two groups, the group with thymoma and the group without thymoma, to evaluate the effect of tumor factors on the outcome of thoracoscopic surgery for myasthenia gravis. Results Forty-seven patients with myasthenia gravis, 20 males and 27 females, with a mean age of 36.6 years, were classified according to the Myasthenia Gravis Foundation of America (MGFA): 18 cases of type I; 14 cases of type IIa; 14 cases of type IIb and 1 case of type IIIa. There were 22 cases in the thymoma group and 25 cases in the nontumor group. The follow-up period was 20 to 122 months, with a mean of 57 months. The percentages of complete stable remission (CSR), pharmacological remission (PR), minimal symptomatic manifestation (MM), worsening (W), relapse (E), and death (D) in the tumor-free group were 78.3%, 13.0%, 4.3%, 0, 0, and 4.3%, respectively, and in the thymoma group were 50.0%, 22.7%, 13.6%, 4.5%, 9.1%, and 0, respectively. conclusion Thoracoscopic The long-term efficacy of enlarged thymectomy in the treatment of myasthenia gravis was satisfactory, and the tumor-free group was better than the tumor group in terms of complete remission rate, but there was no significant difference between the two groups in terms of total effective rate.