Pericardial effusion is the pathological accumulation of fluid in the pericardial cavity and can lead to life-threatening complications such as cardiac tamponade. While pericardiocentesis and surgical pericardial window creation remain the mainstay of treatment, uniportal video-assisted thoracoscopic surgery (UVATS) has emerged as a minimally invasive alternative with potential advantages over conventional approaches. This study comprehensively reviewed the existing literature to evaluate the safety, effi-cacy, and clinical outcomes of UVATS in managing pericar-dial effusion. A comprehensive search across the PubMed, Cochrane, and Google Scholar databases identified studies published from 2000 onward, focusing on the application of UVATS in thoracic surgery. The findings indicate that UVATS is associated with shorter hospital stays, reduced postoperative pain, and lower recurrence rates compared to multiportal VATS and the subxiphoid approach. Addi-tionally, since UVATS is a single-incision technique, this method minimizes intercostal trauma, instead enhancing postoperative recovery. However, challenges remain, in-cluding a steep learning curve, technical limitations, and the requirement for specialized instrumentation. Despite these concerns, UVATS continues to evolve with advancements in instrumentation, imaging, and robotic assistance, further improving its feasibility and outcomes. As the adoption of UVATS grows, future research should focus on long-term efficacy, standardization of techniques, and expanded indi-cations to optimize its role in thoracic surgery.