The purpose of this study was to determine whether thoracoscopy would allow standard lung cancer operations to be performed safely and completely in 80-year-old patients. Elderly patients with lung cancer are usually offered compromise treatment (either radiation or wedge resection) for early-stage lung cancer because their operative risk for lobectomy or pneumonectomy is increased. This study consists of nine patients, 80 to 82 years of age, who underwent either lobectomy (eight cases) or left pneumonectomy (one case) with mediastinal node sampling by thoracoscopy. There were no deaths or major complications. Seven of the nine patients were discharged by the fifth postoperative day. The hospital stay was prolonged in two patients due to air leak or persistent chest tube drainage (11 and 13 days, respectively). The use of thoracoscopy does allow standard lung cancer treatment to be offered to selected elderly patients.