Introduction: Minimally invasive techniques has made tremendous strides in the field of chest wall resections in recent years. We here present a hybrid approach of utilising VATS for resection of difficult to approach chest wall tumor. Methods: A 40-year-old female had presented with right sided chest pain radiating to right arm. Imaging showed a 6 cm well defined heterogenous lesion along right upper lateral chest wall indenting the adjacent parenchyma of apical segment of right upper lobe with erosion of adjacent 2nd rib. Biopsy showed neurofibroma. Due to the location of tumor and the morbidity associated with an open approach for surgery, a hybrid procedure of VATS assisted chest wall tumor resection was planned. Results: The patient was positioned 45 degree left lateral decubitus position with right arm abducted in double lumen endotracheal tube anaesthesia. Thoracoports were placed - 10mm camera port placed in 5th intercostal space just medial to midclavicular line, 5mm working port placed in 5th intercostal space 4 cm medial to the midclavicular line and the tumor was assessed by video thoracoscopy for extent of resection. Simultaneously an external 5cm transverse skin crease incision given along the hair line in right axilla. Under VATS guidance, the margins and extent of resection was assessed and tumor resected. The procedure took 170 minutes with a blood loss of 140 ml. Conclusion: VATS is a useful tool in the armoury of a thoracic surgeon and can be used to assist resection of difficult to approach chest wall tumors.