〔Abstract〕 To compare the clinical outcomes and safety of minimally invasive incisionviavideo-assisted thoracoscopic surgery(VATS) and traditional median full sternotomy incision for aortic valve replacement(AVR). There were 63 patients underwent AVRviaminimally invasive incision as Mini-AVR group including 52 cases through partial upper mini-sternotomy and 11 cases through right anterior minithoracotomy. 135 patients were undergone traditional median full sternotomy AVR as control group(Full-AVR group). The preoperative general data, intraoperative and postoperative indicators and prognosis were compared between the two groups. The clinical effects were also compared between the two minimally invasive incisions. The proportion of New York heart association(NYHA) grade IV in the Mini-AVR group was less than that in the Full-AVR group and the difference was statistically significant(P<0.01). The cardiopulmonary by pass and aortic cross-clamp time in Mini-AVR group were significantly longer than that in Full-AVR group(P<0.01). However, the duration of ICU stay time and post-operative hospital stay, incision length, volume of drainage on the first day postoperative, chest tube duration, and volume of red blood cell transfusion in Mini-AVR group were significantly lower than those in Full-AVR group(P<0.01). The cardiopulmonary bypass(CPB) time and aortic cross-clamp time of right anterior minithoracotomy were the longest in three methods for AVR, with statistically significant difference(P<0.01). The Mini-AVRviaVATS is safe and effective, among which partial upper mini-sternotomy is preferred and right anterior minithoracotomy is the second choice.