Abstract: Video-assisted thoracoscopic surgery (VATS) is one of the most important minimally invasive procedures in the field of thoracic surgery. VATS is now widely used in the diagnosis and treatment of thoracic diseases, especially lung cancers, given its many advantages over traditional thoracotomy. These advantages include minimal invasion, reduced postoperative pain, quicker recovery, shorter hospital stay, and less complication. Some recent studies also indicate that following VATS lobectomy, the long-term survival rate of patients with non-small cell lung cancer is similar to that after conventional surgery. Numerous researchers have also compared immune functions after VATS and thoracotomy. They reveal that VATS can better preserve the immune functions of the body, which benefits the recovery of patients and decreases the opportunity of recurrence. Thus, immune function preservation may be one of the mechanisms of the minimal invasiveness of VATS. This paper reviews reports over the past few years that discuss the effect of VATS on immune functions. The following aspects are given focus: cytokines as well as the number and function of immune cells.