Objective To evaluate the effectiveness of video-assisted thoracoscopic surgery (VATS) for metastatic lung tumors. Methods Clinical records of 31 cases of metastatic lung tumors treated by VATS were retrospectively analyzed. There were 2 cases of lobectomy, 1 case of lobectomy and metastasectomy, 1 case of lobectomy and resection of metastatic tumor in the chest wall, 2 cases of segmentectomy, 20 cases of wedge resection, and 5 cases of wedge resection and metastasectomy. Results No fatal cases were observed. Postoperative complications, including 1 case of respiratory insufficiency, 2 cases of pulmonary infection, 2 cases of continuous alveolar leakage and 3 cases of pleural effusion, were cured by antibiotic therapy and closed thoracic drainage. One case of lung metastasis from primary liver cancer was found lumbar vertebral metastasis at 2 months after operation and was referred to the Department of Orthopedics for further treatment. The 1- and 3-year survival rates were 71.0% (22/31) and 38.7% (12/31), respectively. Conclusions Video-assisted thoracoscopic surgery is a feasible and safe treatment for metastatic lung tumors with surgical indications.