Video-assisted thoracoscopic surgery (VATS) provides a new approach for treating early-stage lung cancer. VATS lobectomy has significant perioperative advantages such having as a lower rate of morbidity and being less immunosuppressive than open lobectomy, and it also provides a shorter recovery time, less postoperative pain, and faster resumption of a normal lifestyle. However, a clear definition of VATS lobectomy is lacking in the current literature. The generally accepted method of VATS lobectomy is from three to four incisions in number of port, 4.0 to 8.0 cm in utility length, and without rib spreading. However, there is still much debate on the role of VATS in lobectomy for the treatment of lung cancer. Concerns regarding safety, the extent of mediastinal lymph node dissection, and long-term survival have made some surgeons apprehensive of its validity for lung cancer. Nevertheless, recent data have shown that VATS lobectomy appears to have equivalent oncological results compared with open lobectomy for patients with early stage non-small cell lung cancer. With growing experience with VATS and development of thoracoscopic instrument, VATS can be beneficial to patients with early stage of lung cancer.