To our knowledge this is the first report entailing urgent awake VATS management of clotted haemothorax. So far, Katlic and Facktor only, reported on VATS performed in spontaneously ventilating patients with haemothorax although in this series unconscious sedation and standard 3-ports approach were employed. Moreover, in the Katlic’s series it is not mentioned whether these procedures were performed in an elective or urgent setting.