In elderly patients with myasthenia gravis, if there is no thymoma and CT hyperplasia of the thymus is not obvious, whether these patients should be actively treated surgically is a problem that is often encountered clinically but difficult to decide. The postoperative pain is very light, only three small holes are made in the chest, no damage to muscles and ribs, recovery is very fast and safe, the incidence of postoperative myasthenia gravis is low, and patients can be discharged 3 days after surgery. For elderly patients with myasthenia gravis, if the effect of oral medication is not satisfactory and the symptoms are getting worse, they should be treated with minimally invasive thoracoscopic surgery regardless of whether they have thymic hyperplasia or thymoma.