Although most abnormal parathyroid glands can be removed through a cervical incision, those deep in the mediastinum have required median sternotomy or formal thoracotomy to correct hyperparathyroidism. To decrease the morbidity associated with these major thoracic procedures, video thoracoscopy was used to remove ectopic mediastinal parathyroid glands in two patients. After removal of an enlarged parathyroid gland, each patient had an uneventful recovery and was discharged within 36 hours.