OBJECTIVE To study the reliability and feasibility of video-assisted thoracoscopic surgery (VATS) for radical resection of early-stage non-small cell lung cancer (NSCLC). METHODS Fifty-four patients with NSCLC treated between Jan. 2007 and Jun. 2010 at our institution were divided into VATS group (n=23) and video-assisted mini thoracotomy (VAMT) group (n=31). The operative time, intraoperative blood loss, number of dissected nodes, pleural effusion drainage, postoperative hospital stay, and visual analogue scales (VAS) were compared between the two groups. RESULTS No deaths or serious complications occurred perioperatively in the two groups. The operative time, intraoperative blood loss, number of dissected lymph nodes or pleural effusion drainage were all comparable between the two groups, but compared with VAMT, VATS was associated with significantly shortened postoperative hospital stay (10.54±1.21 days vs 7.92±0.86 days, P<0.05) and lowered VAS scores (4.26±1.28 vs 2.37±0.25, P<0.05). CONCLUSION VATS for pulmonary lobe resection with systematic node dissection is a feasible approach to the management of early-stage NSCLC.