Objective To compare the effect of thoracoscopic-assisted minimal-incision surgery and conventional thoracotomy in the treatment of multiple rib fractures complicated with lung laceration.Methods A total of 61 patients with multiple rib fractures complicated with lung laceration admitted to the Fourth People′s Hospital of Sichuan Province from October 2007 to May 2019 were retrospectively selected as the research subjects, they were divided into the thoracoscopic group (35 cases) and the traditional thoracotomy group (26 cases) according to surgical methods.In the thoracoscopic group, internal fixation of rib fracture with small incision and repair of lung laceration were performed assisted by thoracoscopy, while in the traditional thoracotomy group, internal fixation of rib fracture and repair of lung laceration were performed with thoracotomy.The operative time, postoperative ventilator assistance time, intensive care unit (ICU) monitoring time, thoracic catheter placement time, hospital stay, intraoperative blood loss, intraoperative fracture number, visual analog scale (VAS) score of pain on the first day after surgery, excellent and good rate of surgical effect and incidence of complications in the two groups were compared.Results The operative time, postoperative ventilator assistance time, ICU monitoring time, thoracic catheter placement time and hospitalization time in the thoracoscopic surgery group were all shorter than those in the traditional thoracotomy group, the differences were statistically significant (P＜0.05).The intraoperative blood loss in the thoracoscopic group was less than that in the traditional thoracotomy group, and the difference was statistically significant (P＜0.05).The VAS score of the thoracoscopic group on the first day after surgery was lower than that of the traditional thoracotomy group, and the difference was statistically significant (P＜0.05).The excellent and good rate of surgery in the thoracoscopic group was higher than that in the traditional thoracotomy group, and the difference was statistically significant (P＜0.05).There were no significant differences in the number of intraoperative internal fixation fractures and the total incidence of complications between two groups (P＞0.05).Conclusions Thoracoscopic surgery with small incisions is better than the conventional thoracotomy surgery in the treatment of multiple rib fractures and pulmonary laceration, for the former one has demonstrated the merits of less trauma, less postoperative pain, recovery in a shorter period and better postoperative effect.Therefore,thoracoscopic surgery with small incisions could be used more in clinical practice.