There have been a few reports of pulmonary resection for lung cancer in patients on hemodialysis (HD), but no reports of video-assisted thoracoscopic surgery (VATS) in these patients have been submitted. We describe two patients on HD undergoing thoracoscopic resection for lung cancer. For the thoracoscopic operation, anatomies of the patients were confirmed by three-dimensional multidetector computed tomography (3D-MDCT). The first patient underwent a right lower lobectomy thoracoscopically, and the second patient underwent a resection of the superior segment of the right lower lobe thoracoscopically. They were discharged on postoperative days 10 and 4, respectively. A review of the literature reveals that morbidity and mortality for pulmonary resection on HD are 74% and 11%, respectively. Thoracoscopic operations for lung cancer patients on HD may minimize the operative invasiveness. Preoperative 3D-MDCT angiography was useful because it supports understanding of the patient's personal anatomy for VATS.