There were many surgical approaches for the ventral or ventrolateral thoracic spinal cord tumor. Six ventrally or ventrolaterally located thoracic spinal tumors were successfully resected through the posterolateral approach. This approach allows direct visualization of the ventral and dorsal boundaries of the tumor with minimal manipulation of the spinal cord. Compared to the traditional laminectomy, visualization of the tumor and spinal cord can be shown to markedly improved. Also, when compared to the transthoracic approach, this approach has be associated with fewer potential complications, such as violation of pleural space and mediastinum, and eliminates the necessity of vertebrectomy. Neurological improvement was obtained in all six patients. It is believed that this approach offers significant advantages for the treatment of ventrally or ventrolaterally located thoracic tumors, and should be considered an to alternative the transthoracic approach.