Aims: This video shows our technique to perform a thoracoscopic enucleation for a large esophageal leiomyoma. Methods: The patient is a 46-year-old woman who was complaining for a worsening dysphagea for the last six months. Barium swallow revealed an esophagus deviation due to 8 cm long compression on the left side, with a normal mucosa. Thoracic CT scan confirmed the presence of a mediastinal oval mass of 38x59 mm, net margins in continuity with esophageal wall causing compression of the lumen. PET-CT was negative. EUS-G confirmed a solid, homogeneus, poorly vascularized lesion at the lever of the upper esophagus. Cytology was non diagnostic. The patient was placed in prone position and three trocars were placed on the right chest. After the division of the pleura near to the azygos vein, the upper esophagus was identified. The azygos vein was dissected and then divided between vascular clips in order to get a better access to the upper esophagus. The esophagus was isolated and surrounded using a surgical sling. The longitudinal muscles of the esophagus were opened in order to get access to the lesion. A transfix suture was placed through the leiomyoma in order to get a better retraction. The lesion was gently dissected from the surrounding structures, avoiding lesion of the mucosa. Muscular layer was closed using a continuous suture. Results: The postoperative course was uneventful and the patient was discharged on postoperative day 2. Histopathological examination showed an esophagel leyomioma.