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Objective: Conventional open esophagectomies are accompanied by a high rate of postoperative complications. Although not yet proven by randomized clinical trials, minimally invasive esophageal surgery appears to be a promising technique that could be associated with a lower morbidity rate. The objective of this study was to compare the results of minimally invasive esophagectomies to conventional open esophagectomies in a non-randomized patient series. Methods: Preoperative characteristics and the postoperative course of patients that underwent a transthoracic esophagectomy for esophageal carcinoma were registered in a prospectively monitored database. The results of patients that underwent a minimally invasive esophagectomy and a conventional open resection were compared. Results: From October 2009 until November 2010 a total of 73 esophageal cancer patients underwent a transthoracic resection of whom 34 by means of a minimally invasive resection. Preoperative characteristics were comparable for both groups. There was a trend towards a shorter hospital stay in the minimally invasive group (10.5 versus 13.5 days, p=0.19). The overall complication rate was 63% in both groups; pulmonary complications were present in 32% of patients in the open TTOCR group versus 31% in the MIE group. Conclusion: The morbidity after a minimally invasive resection or an open transthoracic esophageal resection is comparable. Furthermore, there is a trend towards a shorter hospital stay after minimally invasive surgery. Therefore, minimally invasive esophagectomies appear to be a safe technique for patients with potentially curable esophageal carcinoma.