Lung cancer is the leading cause of cancer death in Taiwan. Surgery provides the best chance for cure and long-term survival in early stage of non-small cell lung cancer (NSCLC). With the advance of minimal invasive surgical technique and instruments, thoracoscopic surgery has emerged as a reasonable alternative in the diagnosis and treatment for NSCLC. In this talk, I will focus on several recent advances of minimal invasive surgery for lung cancer. Firstly, thoracoscopic surgery has increasingly gained acceptance and it is supported by evidence-based treatment guidelines as an alternative to open thoracotomy for managing early stage lung cancer. Recent studies had focused on the use of single-portal thoracoscopy or needlescopic surgery to decrease chest wall trauma. Secondly, less lung parenchyma resection via sublobar resection has become an acceptable alternative to lobectomy in patients with a tumor size less than 2 cm or with poor cardiopulmonary reserve. Sublobar resection is associated with a less complication rate and comparable lung-term survival in highly selected patients. Thirdly, less invasive anesthetic approaches such as nonintubated thoracoscopic surgery via thoracic epidural anesthesia and proper sedation are feasible and safe, which is associated with less intubation- and ventilator-associated complications. Fourthly, preoperative CT localization is an effective modality in identifying small and deep nodules during thoracoscopic surgery. In summary, combination of preoperative CT localization, minimal invasive incision, less pulmonary resection, and optimal anesthesia will definitely make lung cancer surgery safer and make patients more illegible for adjuvant chemotherapy, radiotherapy, or target therapy whenever indicated.