Thoracoscopic surgery without tracheal intubation for a patient with Duchenne muscular dystrophy (DMD) has not been reported. We describe a man with DMD who underwent thoracoscopic bullectomy and pleurodesis using a nonintubated anesthetic technique of internal intercostal nerve block, vagal block, and targeted sedation for recurrent spontaneous pneumothorax. The successful results with this patient suggest that nonintubated thoracoscopic bullectomy and pleurodesis is technically feasible and safe for selected patients with DMD.