Background. The results of investigation and treatment of 1396 patients with blunt chest trauma (952 patients, 68.2%) and chest injury (444 patients, 31.8%) had been analyzed. Materials and methods. The first group consists 552 (39.5%) patients with management without the video-assisted thoracoscopic surgery (VATS), the second one includes 844 (60.5%) patients with VATS. Gender determination: male 1192 (85,4%), and female 204 (14.6%), aged 17-83 years (average 42.5±2.1). Pleural cavity puncture (128 patients), pleural cavity draining (400 patients) and primary wide thoracotomy (24 patients) were used in the 1st group of patients with traditional surgery approach. In the 2nd group of patients in 40 (4.7%) cases of VATS the conversions to wide thoracotomy had been made due faced technically difficulties during the primary VATS technique. Results. Postoperative complications occurred in 92 (10.9%) patients group 2 and in 140 (25.4%) patients, who underwent the traditional approach. The postoperative complications were eliminated by thoracotomy in 28 (5.1%) patients of the 1st group and in 4 patients (0.5%) of the 2nd group. VATS has decreased the frequency of thoracotomy in 5.2% (44 of 844 patients), meanwhile in the traditional approach the thoracotomy has been made in 9.4% cases (52 of 552 patients). Conclusions. Thus, VATS allows not only to establish exact topical diagnosis, but also to quickly and reliably eliminate damages avoiding open intervention with the minimum trauma for the patients.