The first step in the treatment of primary spontaneous pneumothorax (PSP) includes bed rest with supplemental oxygen, simple aspiration and tube thoracostomy. However, video assisted thoracoscopic surgery (VATS) is proposed for recurrent episodes in recent years. Patients with PSP undergoing VATS pleurectomy were retrospectively analyzed in this study. Twenty-one operations were performed on 19 patients between 1997 and 2005. Clinical and demographic data were extracted from hospital’s case notes. Patients were followed up between 4 and 90 months. There were 17 male and 4 female patients (M/F ratio: 4.2/1) with a mean age of 24.6±2.3 (Range: 18 - 43). Of the 21 procedures in total, 13 (62%) was performed to the right and 8 (38%) to the left side. Four (19%), 14 (67%) and 3 (14%) patients were operated on the first, second and third episodes of their pneumothoraces, respectively. Out of 17 (81%) patients with parenchymal lesions, 2 had wedge resection, 3 had ligation of a single bulla. Electrocautery of the bullae was sufficient for the remaining 12 patients. Postoperative drainage time ranged between 2 and 14 days. Postoperative complication occured in 3 patients (14%) due to prolonged airleak in 2 and recurrent pneumothorax in one (%5) who required thoracotomy. Pleurectomy with VATS is a safe and alternative technique for the management of primary spontaneous pneumothorax.