Spontaneous hemopneumothorax is a rare condition and may be a life-threatening condition that needs prompt diagnosis and urgent intervention. In this study, we reported three male cases of spontaneous hemopneumothorax, two cases presented with chest pain and one with epigastric pain. All cases were successfully treated by early surgical intervention. Total blood drainage was ranged from 1400 to 2000 mL. Video-assisted thoracoscopic surgery was performed successfully in two cases, however, one case was transferred to urgent thoracotomy due to excessive blood clotting in the pleura cavity and continuous bleeding. Leukocytosis was observed in two cases, mostly due to pneumonia or sepsis. The bleeding point was identified in all cases, however, the air leak area could not be identified in two cases. Length of hospital stay after admission was ranged from five to seven days. We recommend that video-assisted thoracoscopic surgery should be considered as a first choice due to its effectiveness in reducing postoperative complications and facilitating rapid recovery.