Abstract: Objective To compare the clinical effect between single-port video-assisted thoracoscopic surgery (SPVATS) and traditional thoracoscopic surgery(VATS) in the treatment of spontaneous pneumothorax, and discuss the key points of operation, clinical efficacy and value of popularization of SPVATS. Methods The clinical data of 106 cases of spontaneous pneumothorax in our hospital from January, 2015 to June, 2017 were reviewed. The patients were divided into SPVATS group (64 cases) and VATS group (42 cases). The operative time, bleeding during the operation, drain time, postoperative drainage volume, and length of stay, and VAS in 24 h after the operation were compared between the two groups. Results The operations were successful in both groups, and there was no conversion to thoracotomy case or perioperative death cases. The patients in SPVATS group had significantly lighter postoperative pain than patients in VATS group(t=12.740, P<0.001). The operation time(50.39±9.58)min, intraoperative blood loss (42.70±9.54)ml, chest tube drainage time (3.31±0.90)d, postoperative drainage volume (235.62±74.38)ml and postoperative length of hospital stay (4.73±1.38)d showed no significant difference between two groups (P>0.05). Conclusion Single-port video-assisted thoracoscopic surgery in the treatment of spontaneous pneumothorax has the same safety, easy operation and less pain as compared with VATS, which is worth to be promoted.