Breast conservation surgery (BCS) is the standard surgical treatment for early breast cancer. It produces equivalent oncologic outcome but better aesthetic result, psychological outcome and quality of life when compared with mastectomy. However, conventional BCS leaves a gross incision scar remains on the breast that affects the aesthetic result. Video-assisted breast conservation surgery (VABCS) can be performed via small and remote incisions that become inconspicuous after surgery. Clinical trials demonstrated that VABCS is feasible and safe. There is currently no level 1 randomized clinical evidence. However, VABCS can be considered as a surgical option for patients with early breast cancer.