Purpose: To improve postoperative outcomes in patient undergoing VATS for spontaneous pneumothorax, through finding the difference between using of each VATS procedure in such patients, as there is debate in preference of one technique over the other in previous literatures. Methods: It is a comparative study on spontaneous pneumothorax patients (primary or secondary) undergoing VATS in Assiut university heart hospital from January 2017 till April 2019. Patients included in our study were whom obvious bullous forms are seen in PSP pneumothorax lines, Recurrent pneumothorax, Bilateral pneumothorax, Previous history of contralateral pneumothorax, Spontaneous hemothorax, Air leakage more than 5 days with drainage catheter for 1st attack patients .those Patients were divided into 2 groups: group (A) patient will undergo uniport VATS procedure and group (B) patient will undergo biport VATS procedure. Exclusion criteria include patient refusal or reoperation case. Results: included 32 patients, 22 were primary spontaneous pneumothorax while 10 were secondary spontaneous pneumothorax. 18 patients underwent Uniport VATS and 14 underwent biport VATS. Mean time for operation was 81.5±33.74 in uniport VATS versus 109.79±25.37 in biport VATS (P-value =0.014). No significant statistical difference was found between uniport and biport VATS regarding pain, air leak, complications, hospital stay, recurrence, and mortality. Despite no statistical difference regarding mortality(p-value=0.492), there were 2 mortalities in uniport VATS group known to be interstitial pulmonary fibrosis. Conclusion: We concluded that there are no differences between both techniques except for operative time. The use of any technique is for surgeon preference. In our center, uniport VATS became the most used technique and biport technique used when there is a need to convert from the uniport technique.