Abstract: Objective To search for the clinical feasibility and advantage of subaxillary small incision thoracotomy in the primary lung cancer. Methods From January 2001 to June 2008, 338 consecutive cases were randomly divided into two groups，namely,experimental group (158 cases) with transaxillary thoracotomy (TT) and control group (180 cases) with traditional posterolateral thoracoromy (TPT) ). Results Mean incision length ［(10.61±1.29) cm］ in experimental group was shorter than that［ (26.50±4.96)cm］ in control group significantly (P< 0.001). Significant shorter operation time was spent on experimental than on control group operation ［ (120.42±30.10)min, (158.31±28.01) min, P< 0.001］. Bleeding volume in experimental group was markedly less compared to control group ［(190.05±78.65)ml, (250.10±110.23)ml, P< 0.001］. Post-operative drainage volume in experimental group was significantly less than that in control group ［(420.16±120) ml, (510.30±151.20)ml， P< 0.001］. The hospitalization time after operation in experimental group was significantly shorter than that in control group［（10.89 ±4.49）d, (14.65±3.55)d］.The average lymph nodes, was no significant difference between the two groups (14.31±5.98 vs15.12±6.27, P＞0.05).The prevalence of shoulder movement disfunction and other complications in experimental group was obviously decreased than that in control group. Conclusion The transaxillary operation was a simple approach with excellent operation field, limited trauma, little bleeding, reduced post-operative pain, less disturbance of shoulder movements，shorter operation time and hospitalization,compared with the traditional posterolateral thoracotomy.