Objective:To explore the advantages and disadvantages of vertical axillary muscle-sparing thoracotomy.Methods: Forty-five patients were operated on with this approach for various intrathoracic lesions,and the operation results were analysed.Results:The technique was simple and quick.Postoperatively,this procedure was associated with less pain,less limitation of shoulder girdle movement and excellent cosmetic healing.Conclusions: This approach offers an alternative to the standard muscle cutting posterolateral thoracotomy for elective procedures.When chest wall resections or extremely difficult upper lobectomy or hilar dissections are anticipated,this approach is not suggested.