Objectives: To evaluate utility of video-assisted thoracoscopic surgery (VATS) as definitive management of patients with traumatic chest injury. Patients & Methods: The study included 153 chest trauma patients; 105 had solitary thoracic injury and 48 had thoracic injury as a part of multiple body trauma. All patients were evaluated using the Injury Severity Scale scoring and severity of thoracic vascular, lung, cardiac and diaphragmatic injuries were graded according to the American Association for the Surgery of Trauma. Patients were categorized according to at arrival systolic blood pressure (SBP) and patients with SBP60 mmHg were fully investigated and underwent thoracoscopy (therapeutic or diagnostic) and in case of diagnostic thoracoscopy, open thoracotomy was performed. Results: Thoracoscopy worked good as therapeutic modality for 96 patients and as a diagnostic modality for 14 patients. Thoracotomy was applied for 42 patients with SBP