Myxomas are the most common type of primary cardiac tumors. We report our use of totally thoracoscopic surgery in resecting cardiac myxomas in 12 cases with 10 in the left atria and 2 in the right atria. Totally thoracoscopic surgical resection of myxoma was successfully performed in all cases through three minimal incisions, with the largest incision less than 3 cm. The cardiopulmonary bypass time was 96 to 126 minutes, and the aortic cross-clamp time was 46 to 63 minutes. Postoperative ventilation assistance was 3 to 11 hours. We show that the method is safe and achieves complete tumor resection. © 2010 The Society of Thoracic Surgeons.