Background. The purpose of the current study is to present the clinical and surgical results in patients who underwent hybrid video-assisted thoracic surgery with segmental–main bronchial sleeve resection. Methods. Thirty-one patients, 27 men and 4 women, underwent segmental–main bronchial sleeve anastomoses for non–small cell lung cancer between May 2004 and May 2011. Results. Twenty-six (83.9%) patients had squamous cell carcinoma, and 5 patients had adenocarcinoma. Six patients were at stage IIB, 24 patients at stage IIIA, and 1 patient at stage IIIB. Secondary sleeve anastomosis was performed in 18 patients, and Y-shaped multiple sleeve anastomosis was performed in 8 patients. Single segmental bronchiole anastomosis was performed in 5 cases. The average time for chest tube removal was 5.6 days. The average length of hospital stay was 11.8 days. No anastomosis fistula developed in any of the patients. The 1-, 2-, and 3-year survival rates were 83.9%, 71.0%, and 41.9%, respectively. Conclusion. Hybrid video-assisted thoracic surgery with segmental–main bronchial sleeve resection is a complex technique that requires training and experience, but it is an effective and safe operation for selected patients.