Abstract: Objective: To determine the value of mediastinoscopy in the mediastinal staging of lung cancer. Methods: The study was retrospective, a total of 69 patients underwent mediastinoscopy for known or suspected lung cancer. These consisted of 57 cervical mediastinoscopies, 7 parasternal mediastinoscopies, 5 combined procedures. All the patients were detected enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0 cm on its shortest axis). Results: Of the 69 patients, 50 patients were found with N2 or N3 disease on mediastinoscopy. Among 19 mediastinoscopy -negative patients, 15 underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, thoracotomy-proven N0 was found in 14 patients, N2 in 1 patients (false-negative mediastinoscopy). The sensitivity, specificity, and accuracy of mediastinoscopy for the mediastinal staging of lung cancer were 98%, 100%, and 98.51, respectively. In the entire group of 69 patients, there were 1 complications (1.4%), no perioperative death. Conclusion: Mediastinoscopy is a highly effective and safe procedure. It should be used routinely in the mediastinal staging of lung cancer.