Introduction: Retained haemothorax and pleural empyema are the most common complications of thoracic trauma (TT). TT is a major cause of morbidity and mortality in specialized surgery trauma centers. With the increased potential of the mini-invasive surgery, video assisted thoracoscopy (VATS) has become an elective method of treatment for these patients. Aim: To evaluate the usefulness of video assisted thoracoscopy in the management of the patients with complicated thoracic trauma and active bleeding. Material & Methods: 523 patients were included in the study carried out during the period 2016-2017 at the Institute of Emergency Medicine from Chisinau, Republic of Moldova. M:F – 2:1. 126(24.3%) patients had pleuropulmonary complications, 68(13%) – hemothorax, 58(11.1%) – posttraumatic pneumothorax. All patients with baseline pleuropulmonary complications were subjected to pleural drainage. Results: 5(0.76%) patients underwent VATS to manage pleuropulmonary complications, 3 patients were identified with retained hemothorax, one patient with pneumothorax as a result of pulmonary parenchymal lesion, one patient with pleural effusion. No patient in the study group was subjected to conversion to open thoracotomy. Conclusions: Retained haemothorax is the most frequent complications after TT. VATS is the method of choice in patients with complicated thoracic trauma unresolved by pleural drainage and performed over 24 hours from hospitalization. VATS reduces the rate of late complications and the period of hospitalization for patients. VATS can be used in the management of active thoracic bleeding