The present work describes graphically and sumarily two of the most used surgical approaches by the Spine Surgery Service of the Hoch Taunus Klinik Bad Homburg from Germany, for the treatment of the thoracic spine pathology. This service with more than 20 years of experience in these techniques, usually receives profesionals from different parts of the world in order to become familiar with these treatments. Dr Daniel J Rosenthal implemented for the first time in his service the thoracoscopic approach for the treatment of a thoracic disc herniation in the year 1992, since then he has accumulated more than a 1000 procedures in the thoracic spine with the use of adecuatelly and endoscopically invasive techniques. The easy comprehension and description step by step make this work a useful reference material for spine surgeons, orthopedists and neurosurgeons who want less agressive alternatives when deciding on the treatment of thoracic spine pathology. As complementary audiovisual material, videos of surgical procedures performed by this team of spine surgeons are provided to the reader. Endoscopic Approaches to the Thoracic Spine. Endoscopically assisted retropleural approach & Thoracoscopic approach to the spine