Objective To explore the safety and feasibility of subxiphoid thymectomy for thymic tumor and myasthenia gravis. Methods A retrospective analysis was made of 54 patients who underwent thoracoscopic thymectomy since 2014. Among them, 27 underwent subxiphoid thymectomy and 27 underwent intercostal thymectomy. The clinical indicators, post-operative pain scores, and complications of the two groups were analyzed. Results All operations were carried out smoothly. No intraoperative anesthesia accident occurred. There was no conversion to thoracotomy in subxiphoid group and there was 1 case of the conversion in intercostal group. There was no significant difference in operation time, intraoperative bleeding volume, postoperative pleural fluid volume, and thoracic tube indwelling time between the subxiphoid group and the intercostal group(P>0.05). The hospitalization time in the subxiphoid group was significantly shorter than that in the intercostal group [(4.22±1.99)days vs(7.44±2.12)days], and the difference was significant(P<0.05). The VAS scores of Subxiphoid group at 24, 48, and 72 hours after operation were significantly lower than those in the intercostal group[(2.52±0.85),(1.74±0.81), and(1.33±0.73)vs(3.74±1.97),(2.63±1.80), and(2.00±1.57)]. The differences between the two groups were signifcant(P<0.05). Perioperative complications in Subxiphoid group were lower than those in intercostal group(7.4% vs 18.5%), but there was no significant difference(P>0.05). Conclusion Subxiphoid thymectomy is safe and feasible, with light pain and quick recovery. It is a relatively perfect surgical method for thymic tumor and myasthenia gravis.