[Abstract]With the adoption of the surgical principles emphasizing minimally invasive, precise, and individualized procedures, the subxiphoid video-assisted thoracoscopic surgery with sternal elevation has become a pivotal approach for resecting anterior mediastinal masses. This approach significantly enhances surgical exposure, minimizes operative trauma, alleviates postoperative pain, and improves cosmetic outcomes. To establish a standardized framework and regulate the application of this approach, this consensus integrates practical experience from thoracic surgery centers in China alongside evidence from the literature. The core issues addressed in this consensus include surgical indications, preoperative assessment, anesthesia and intraoperative coordination, critical surgical techniques, postoperative management, complication prevention and treatment, as well as training and quality control systems. This consensus aims to provide a safer and more effective minimally invasive technique for patients with anterior mediastinal masses and to advance the innovation in minimally invasive anterior mediastinal surgery.