OBJECTIVE AND IMPORTANCEWe describe combined laminectomy and thoracoscopic surgery for removal of a dumbbell thoracic spinal tumor to demonstrate the feasibility of such an approach.CLINICAL PRESENTATIONWe present the case of a 29-year-old man who developed chest pain and spinal cord compression from a thoracic dumbbell neurofibroma.TECHNIQUESurgical approaches for benign nerve sheath tumors that extend from the spinal cord into the thoracic cavity include combined laminectomy and thoracotomy either in one or two stages, or a lateral extracavitary approach involving laminectomy, facetectomy, and rib resection in a single stage. We performed a combination laminectomy and thoracoscopic tumor resection in a single stage with good results.CONCLUSIONThis technique has not been reported previously in the literature. It has the advantage of avoiding the potential morbidity of a thoracotomy, as well as the extensive muscle dissection and pain associated with the lateral extracavitary approach.