Objective To evaluate the feasibility and safety of complete video-assisted thoracoscopic surgery (VATS)anatomic segmentectomy. Methods Clinical data of 26 patients with lung diseases who underwent complete VATS anatomic segmentectomy in the First Affiliated Hospital of Nanjing Medical University from November 2010 to July 2011 were retrospectively analyzed. There were 8 male and 18 female patients with their age of 13-81 (53.2±3.1) years. There were 23 patients with pulmonary nodules including 13 patients who underwent direct surgical resection and 10 patients with ground-glass opacity nodules (3 patients received preoperative localization and the other 7 patients received direct surgical resection). All the 3 patients with non-nodule pulmonary diseases (bronchiectasis, pulmonary bulla and pulmonary cyst respectively) underwent direct surgical resection. Results All the 26 patients received complete VATS anatomic segme- ntectomy successfully. The operation time was 150-250 (193.7±7.3) min,and intraoperative blood loss was 10-200 (65.7±12.7) ml. Patients with lung cancer received 4-7 (5.1±0.3) stations of lymph node dissection and the number of lymph node dissection was 4-16 (12.3±0.5) for each patient. There was no in-hospital death or postoperative complication. Postoperative thoracic drainage time was 3-7 (3.9±0.4) days. All the patients were discharge uneventfully. Lung cancer patients were followed up for 3-6 months without recurrence or metastasis. Conclusion Complete VATS anatomic segmentectomy is a safe and feasible surgical procedure.