Abstract Esophageal leiomyoma is the most common benign tumor of the esophagus. Although enucleation via thoracotomy has been considered standard treatment, minimally invasive surgery is increasingly used for the treatment of this disease. The authors report the clinical outcomes of three procedures for enucleation. Methods From November 2011 to December 2020, 3 females (52, 58, and 67 years old) patients were treated for leiomyoma of the middle third of the esophagus. A history of dysphagia and chest pain was present. Upper gastrointestinal endoscopic, computerized tomography, and endoscopic ultrasound were performed, in only one case barium swallow was used. Results The surgical approaches included right thoracoscopy in prone position, enucleation, and small thoracotomy for removing the specimen. There were no major morbidities, including deaths. One patient presented a leak, which was resolved with an endoscopic stent. Conclusion Minimally invasive enucleation of esophageal leiomyoma can be performed effectively and safely. Right thoracoscopic in prone position for the removal of esophageal leiomyomas may be recommended as the treatment of choice in centers experienced with esophageal surgery.