A 47-year-old female presented to the hospital with a complaint of chronic pain in the right posterior upper chest which last for 2 years, with concomitants attacks of dyspnea and a dry cough. The patient revealed that she had episodes of dizziness without any triggers. She has been known to be a nonsmoker and nonalcoholic, with no history of past surgery or malignancy. She was diagnosed with mitral valve regurgitation during her visit to the cardiologist 5 years ago. Family history is not contributory. The physical examination revealed numbness and hypoesthesia at the T5–T6 dermatomal distribution, while the motor examination was intact with normal muscle strength and tonicity. A plain chest radiography showed a round hyper-density mass with central calcification. The mass is located at the right upper thorax. The computed tomography (CT) of the chest revealed that the mass was centered at the right T5 and T6 costovertebral junction measuring 5×3×2.8 cm with internal and external calcification. The mass extended in the right thorax with rib distribution. However, the lesion did not affect the T6 neuroforamen. Preoperative MRI showed a heterogeneous round mass, MRI T2 very high central intensity calcified portions. At the costovertebral junction extending to the right fifth thoracic neural foramen, without spreading to the right epidural space. The first operation was an excisional biopsy by video-assisted thoracic surgery. Under general anesthesia and decubitus position, we placed a left double lumen endotracheal tube to make one lung ventilation. A 10 trocar was inserted in the sixth and fifth intercostal spaces at the posterior and median axillary lines, respectively. The total mass was resected without ribs or vertebral bodies and sent for histopathological study, which revealed a low-grade chondrosarcoma. The second surgical procedure (resection of the tumor): This second surgery was done 4 weeks after the video-assisted thoracic surgery. The patient was placed in the prone position, under general anesthesia, and one- lung ventilation was done with ‘left double lumen endotracheal tube’. A right para median incision from the third to sixth intercostal spaces were made with a 15 blade. Then, the laminae of the fourth and fifth vertebra were exposed for laminectomy from the right side with their transverse processes. Eventually, the spinal dorsal ganglion and the intercostal neurovascular bundle were resected completely. A right posterior-lateral fourth intercostal incision was made before entering the thoracic cavity, and the pneumonolysis was done by investigating the entire thoracic cavity to examine any neoplastic tissues. Then, excising nearly 5–7 cm of the ribs (fourth, fifth, sixth, and seventh), in addition to an extra 5 cm excision of the sixth rib as a safety margin. After all, about ½ cm from each one of the (4, 5, 6, and 7) ribs was removed to send it as a separate sample for pathological study to confirm free margins. This case report was conducted in accordance with the Surgical Case Report (SCARE) criteria.