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To evaluate the feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis performed without patient repositioning. A retrospective analysis was performed on the clinical data of patients who underwent thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis without patient repositioning at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from August 2016 to January 2020. A total of 39 patients were enrolled (32 males and 7 females), with the age of (64.2±7.2) years. The patients' surgical status, postoperative pathological stage, postoperative complications, and follow-up information were analyzed. The survival curves were plotted using the Kaplan-Meier method. All 39 procedures were completed successfully with no conversion to thoracotomy or laparotomy. The operative time was 250.0 (223.5, 289.0) min, and intraoperative blood loss was (165±79) ml. Postoperative pathological stages were stage Ⅰ in 13, stage Ⅱ in 4, stage Ⅲ in 11, and stage Ⅳ in 11 patients. R0 resection was achieved in all patients. Postoperative complications included anastomotic leakage in 3 patients (7.7%, 3/39), pulmonary infection in 3 patients (7.7%, 3/39), arrhythmia in 3 patients (7.7%, 3/39), pleural effusion in 3 patients (7.7%, 3/39), incision infection in 1 patient (2.6%, 1/39), gastroesophageal reflux in 5 patients (12.8%, 5/39), and iatrogenic injury of the right mediastinal pleura in 3 patients (7.7%, 3/39). All complications were resolved after conservative treatment. There were no cases of chylothorax, reoperation, ICU admission, or perioperative death. The patients were followed up for a median of 55 (36, 60) months postoperatively. The 1-year and 3-year disease-free survival rates were 87.2% and 69.2%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 92.3%, 74.4%, and 48.1%, respectively. Thoracolaparoscopic adenocarcinoma of the esophagogastric junction resection with left intrathoracic anastomosis performed without patient repositioning appears feasible and has clinical value for broader adoption.