Extramedullary hematopoiesis is a rare cause of an intrathoracic mass in individuals with hemolytic disorders. It can be clinically confused with other tumors of the mediastinum. While radiologic studies often demonstrate findings suggesting intrathoracic extramedullary hematopoiesis, histology is usually required for diagnostic purposes. Thoracotomy was the mainstay procedure for obtaining tissue diagnosis and resection. However, video-assisted thoracoscopy (VATS) is an amendable and less-invasive means of tumor removal. We report a case of a posterior mediastinal extramedullary hematopoietic mass in a forty-two year old male in which VATS was utilized for diagnosis and resection.