Objective: In this study, we aimed to compare the results of patients who underwent surgery by thoracotomy and Video-assisted thoracoscopic surgery (VATS) in mediastinal neurogenic tumors. Materials and Methods: Twenty-six consecutive cases (12 males and 14 females; mean age 39.4 ± 22.3 years; range 1–72 years) who were histopathologically diagnosed as having mediastinal neurogenic tumors between January 2000 and August 2020 were included in a single-center, retrospective study. Results: There were 5 (19.2%) children and 21 (80.8%) adults. Lesions in all cases were located in the posterior mediastinum. Schwannoma was detected histopathologically in 18 cases (69.2%), and all of these cases were adult patients. Resection was performed by thoracotomy in 14 cases (7 right and 7 left) and 12 cases by thoracoscopy (7 right and 5 left). The mean tumor size was 7.4 ± 1.9 cm (range 5–12 cm) in the thoracotomy group and 4.3 ± 1.9 cm (range 2–7 cm) in the VATS group (P = .001). Mean operative time was 101.7 ± 27.8 min (range 70–150 min) in the thoracotomy group and 77.9 ± 24.3 min (range 60–150 min) in the VATS group (P = .014). Mean postoperative hospital stay was 7.4 ± 4.0 days (range 3–20 days) in the thoracotomy group and 4.7 ± 1.7 days (range 2–7 days) in the VATS group (P = .040). Conclusion: Most of the mediastinal neurogenic tumors are benign and surgical resection is required in their treatment. With increasing experience, resection can be performed thoracoscopically in most cases.