Historically, thoracic disc pathology has been treated via open thoracotomy or open posterior costotransversectomy or lateral extracavitary approaches. However, these approaches are associated with approach-related morbidity. With advancement in such minimally invasive approaches as the lateral interbody fusion coupled with navigation, the morbidity of approaching anterior thoracic spinal pathology may be reduced. There are subtleties and nuances in the thoracic approaches that are different from the lateral lumbar interbody approaches. We discuss our technique of the minimally invasive approach to the thoracic spine, management of the rib and pleura, and incorporation of navigation into the procedure.