Purpose To present the first documented Australian case of uniportal subxiphoid video-assisted thoracoscopic surgery (VATS) thymectomy. The subxiphoid approach appears to be gaining anecdotal adoption in Australia, but the uniportal technique has not yet been formally reported. International experience shows this method offers excellent anterior mediastinal access, bilateral phrenic nerve visualisation, and reduced postoperative pain. Methodology We describe a 73-year-old female with an incidentally detected central thymic mass. Patient factors—including osteoporosis and bilateral breast implants—made sternotomy or lateral VATS less desirable. A uniportal VATS thymectomy was performed via a subxiphoid incision, followed by xiphoidectomy to create a retrosternal workspace. No CO₂ insufflation was required. The bilateral pleura was opened, and dissection was completed using an advanced vessel-sealing device under alternating single-lung ventilation. Both phrenic nerves were identified and preserved, and the innominate vein was identified and controlled. The thymus was retrieved in an endoscopic specimen bag, and bilateral pleural drains were placed. The procedure was video recorded with patient consent for educational purposes. Results The case was completed without conversion. Postoperative pain was notably less than in other thymectomy cases within our unit. The patient had an uncomplicated recovery, mobilised early, and was discharged on postoperative day 3. Histopathology revealed a Stage IIb thymoma with R0 resection and close margins. No adjunct therapy was recommended after multidisciplinary review, and the patient remains disease-free at 12-month follow-up. Conclusion This first reported Australian uniportal subxiphoid VATS thymectomy demonstrates that the technique is feasible, safe, and may reduce postoperative morbidity. These findings support further adoption and evaluation of uniportal subxiphoid thymectomy within the Australian surgical setting. Keywords thymectomy; subxiphoid; uniportal; VATS; thymoma; minimally invasive surgery