The operative techniques in the treatment of myasthenia not associated with the presence of thymoma are presented. The advantages and disadvantages of thymectomy performed through a cervical approach, extended maximal thymectomy using the cervical–substernal–videothoracoscopic approach, and extended thymectomy via a single substernal incision are analyzed. The issues of repeat thymectomy procedures and atypical surgical methods for the treatment of thymomas are also discussed.