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Intercostal nerve sheat tumors are rare and normally benign tumors. The successful thoracoscopic resection of an intercostal neurilemmoma is reported. It occurred in an asymptomatic 44 year-old woman. Diagnostic flowchart consisted in an enhanced CT of the chest and in a fine needle biopsy under CT guidance of the chest wall mass. The videothoracoscopic resection was carried out with three small incisions, in a relatively brief time and without high technical difficulties. Postoperative course was uneventful and the patient was discharged in the fourth postoperative day. In authors' opinion thoracoscopic approach is actually mandatory as a first attempt to cure benign neurogenic tumors of the chest wall.
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