Performing complex surgical procedures in patients with situs inversus totalis is a challenge because of the need to orient to the completely mirror transposed abdominal and thoracic viscera. We report our experience in performing a three phase minimally invasive (thoracoscopic and laparoscopic) esophagectomy for carcinoma of the mid esophagus in a patient with situs inversus totalis. We believe that this is the first reported case of this kind.