Neurogenic tumors of the thorax can originate in any neurogenic structure within the chest. Surgical resection is considered the primary treatment of such tumors and usually is performed through a thoracotomy. Recently, using a new approach, we applied the technique of video thoracoscopic surgery to resection a posterior mediastinal tumor. In this paper, we report three patients with superior-posterior mediastinal neurogenic tumors in which the approach to the tumor is technically difficult. Cases 1 and 2 were a 26-year-old man and a 50-year-old asymptomatic man, respectively, and case 3 was a 45-year-old asymptomatic woman. The sizes of the three tumors were 3.0 x 2.5 x 1.8 cm (case 1), 6.0 x 4.0 x 2.0 cm (case 2), and 3.0 x 2.0 x 2.0 cm (case 3). In one case (case 2), minithoracotomy was added to video thoracoscopic surgery for adhesion to the spinal artery and intraspinal extension. A standard thoracotomy was avoided in all three cases. All patients had uncomplicated postoperative courses. Video thoracoscopic resection of a neurogenic tumor in the superior-posterior mediastinum may be a safe and useful approach with improved cosmetic results.