ObjectiveTo analyze the short-term outcomes of cardiac surgery via minimally invasive approach under thoracoscope in a single-center. Methods The clinical data of patients who underwent cardiac surgery via minimally invasive approach under thoracoscope between July 2017 and February 2022 were retrospectively analyzed. Results A total of 453 patients were enrolled, including 150 males and 303 females at an average age of 42.2±14.6 years. The main disease types included atrial septal defect in 314 patients, partial atrioventricular septal defect in 26 patients, and cardiac tumor in 105 patients. There was no death during the perioperative period. The mean operative time was 3.9±0.8 h, cardiopulmonary bypass time was 101.2±34.0 min, aortic occlusion time was 42.1±25.1 min, ventilator assistance time was 11.6±9.4 h, ICU stay time was 22.6±13.9 h and postoperative hospital stay was 6.0±1.7 d. Intraoperative and postoperative complications occurred in 18 (4.0%) patients, including 2 patients with conversion to sternotomy, 3 with incision expand, 3 with reoperation for bleeding, 1 with of redo operation, 4 with incision infection, 2 with respiratory insufficiency, 2 with cerebrovascular accident, and 1 with ventricular fibrillation. The follow-up time was 22.6±15.4 months, during which 1 patient died, 4 patients had moderate mitral regurgitation, 1 patient had mild-moderate mitral regurgitation, and 1 patient had mild-moderate tricuspid regurgitation. Conclusion Minimally invasive cardiac surgery under thoracoscope is safe with small invasions and few complications, and has satisfactory short-term outcomes.