Objective To observe the clinical effects of ultrasound‑guided T5 paravertebral nerve block combined with erector spinae plane block in video‑assisted thoracoscopic surgery. Methods Forty patients with an American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ scheduled for elective single‑port thoracoscopic lobectomy were allocated to ultrasound‑guided T5 erector spinae plane block group (group E) and ultrasound‑guided T5 paravertebral nerve block group combined with erector spinae plane block group (group E+P), according to random number table method. Before induction of anesthesia, group E received T5 ultrasound‑guided erector spinae plane block, and group E+P received T5 ultrasound‑guided erector spinae plane block combined with paravertebral nerve block. The operation time and the width of block plane, Visual Analogue Scale (VAS) for rest and cough at 0, 2, 4, 8, 12, 24 h and 48 h after surgery, the number of patient controlled analgesia (PCA) pump pressings as well as the length of hospital stay were recorded. Results There was no significant difference in the operation time and the width of block plane between the two groups (P>0.05). Hoverer, the VAS scores of rest and cough at 0, 2, 4, 8, 12, 24, 48 h after operation in group E+P were significantly lower than those in group E (P<0.05). The number of PCA pump pressings was significantly less and the average length of hospital stay was shorter in group E+P than those in group E (P<0.05). Conclusions Ultrasound‑guided T5 paravertebral nerve block combined with erector spinae plane block can significantly reduce pain after thoracoscopic lobectomy and shorten the length of hospital stay, which is worthy of clinical application.