Transthoracic discectomy and fusion were performed on 19 patients for a central or central-lateral herniated thoracic disc. At initial visit, 14 patients had evidence of myelopathy, 5 had bowel or bladder dysfunction, and 13 had pain. Previous laminectomy in three patients compromised the result of later anterior decompression. Coexistent multiple sclerosis was diagnosed in two patients, who had an atypical postoperative course. The overall results of transthoracic discectomy and fusion in patients without prior laminectomy or coexistent multiple sclerosis were excellent in six, good in six, fair in one, and poor in one, demonstrating that it is a safe and effective procedure.