The objective of the present study was to investigate the effects of video-assisted thoracic surgery on the treatment of lung cancer in elderly patients. A total of 89 patients with lung cancer who underwent video-assisted thoracic surgery or open thoracotomy were enrolled in the present study, in which 44 cases underwent the video-assisted thoracic surgery while 45 cases were treated with open thoracic surgery. The mean operation time, the mean intraoperative blood loss, the average postoperative hospital stay, and the average postoperative chest tube duration were analyzed. The results showed that although no statistical difference existed in the mean operation time and the mean intraoperative blood loss, the average postoperative hospital stay and the average postoperative chest tube duration in the experimental group were significantly lower than those in the control group (P < 0.05). In conclusion, compared with the open thoracic surgery, the video-assisted thoracic surgery has better clinical effects and lower complications. © 2016 Taylor & Francis Group, London.