Abstract: Objective　To report the anatomical study and clinical effect of supraclavicular endoscopic surgery for thoracic outlet syndrome.　Methods　Adult specimens were selected to study anatomically the structures of the lateral cervical region and the anterior cervical region, and the supraclavicular approach was selected for endoscopic simulation operation to determine the optimal approach point. According to the results of anatomical study, endoscopic supraclavicular approach was applied in the treatment of thoracic outlet syndrome.　Results　Anatomic study showed that the best approach of endoscopic surgery was  the intersection point between the sternocleidomastoid muscle and 60% of the total length of the sternocleidomastoid muscle and the posterior margin of the sternocleidomastoid muscle when the head was slightly inclined to the opposite side at 60 °. The transverse cervical artery was the anatomic specific marker of endoscopic operation. Five patients underwent endoscopic supraclavicular approach surgery clinically. The mean follow-up time was 25 months (12~36 months). According to Roos criteria, 4 cases were excellent and 1 case was good.　Conclusions　Endoscopic surgery via supraclavicular approach for thoracic outlet syndrome has its anatomical basis, and its clinical application is safe and feasible. It can effectively relieve the compression of brachial plexus in thoracic outlet syndrome with satisfactory effect.

Key words: Thoracic outlet syndrome;　Supraclavicular approach;　Endoscope;　Minimally invasive; ,  Anatomy and clinical application