Hand sweating is a rather common functional localized abnormal sweating of unknown origin. The secretion of human sweat glands is controlled by the sympathetic nerves, and primary hand sweating is caused by dysfunction of the sympathetic nervous system, such as tension, excitement, stress, or abnormal increase in palm sweating due to summer heat. Most of them suffer from hand sweating since childhood, and it becomes more serious in adolescence. The incidence of primary hand sweating in the population is 2.8%, and 15.3% have a family history of the disease. Although hand sweating is not a major health problem, it can cause a lot of inconvenience and embarrassment in life, work and social interactions. People with a tendency to sweat excessively have wet palms most of the time, and chronically wet hands often cause peeling. Teenagers of school age often get their exam papers wet due to excessive hand sweat, often before the papers are written. Teenagers are afraid to hold hands with others, and even shaking hands becomes a problem. In severe cases, the palms of the hands may even develop eczema dermatitis. As adults, they also cause inconvenience at work and social activities. These are not serious diseases, but excessive sweating puts patients in a daily state of helplessness, agitation or panic, causing great inconvenience to their work, social and life, and seriously affecting their self-confidence. The patient’s psychological pain is so great that it is difficult for ordinary people to understand. The treatment of hand sweating has long been a difficult problem. Non-surgical treatment (including astringents, antiperspirants, absorbents, sedatives, anticholinergic drugs, etc.) is not only very ineffective, but also difficult to apply long-term because of its side effects; therefore, surgical treatment has become a major trend. The sympathetic nerve that controls the sweat glands in the hands is located in the second to fourth section of the thoracic spine (T2-4), which is about the nipple line, and then a little higher on both sides of the back vertebrae, and as long as this section of the thoracic sympathetic nerve is cut, the purpose of not sweating in the hands can be achieved. Thoracic sympathectomy is now recognized and proven to be the only effective and long-lasting treatment for hand sweating to date. The application of thoracoscopy has brought the treatment of hand sweating into a new historical period, as thoracoscopic surgery is less invasive, better exposed, accurately positioned, safe and reliable, and quicker to recover after surgery, thus, eradicating hand sweating is no longer a difficult and unacceptable treatment. The application of thoracoscopic thoracic sympathectomy, using minimally invasive treatment of hand sweating, without opening the chest, only two small incisions of 1 cm each in the axilla of the patient’s bilateral chest wall, through one hole into the thoracoscope, the other hole into the operating instruments, and then under television surveillance in only 30 minutes that is accurate, simple and fast to complete the operation. The patient had almost no bleeding and minimal pain. The patient’s hyperhidrosis was eliminated immediately after the operation and he was discharged from the hospital in 2-3 days. Television thoracoscopic thoracic sympathectomy has become the only effective and long-lasting method for the treatment of hand sweating with exact and satisfactory results and a 100% postoperative satisfaction rate. Thoracoscopic sympathectomy, with its clear efficacy, safety and reliability and minimally invasive features is widely used. If the hand sweating does not cause much damage to the body, if the patient feels that it seriously affects interactions, work and study, he or she will have indications for surgery. The majority of patients with hand and axillary sweating symptoms disappear after surgery and return to normal work life in about 2 weeks. Psychometric studies have also shown a significant improvement in the psychological health of patients after surgery. The thoracoscopic technology of our department has developed rapidly in recent years and has reached the advanced level in China and the leading level in the province, successfully carrying out the minimally invasive treatment of hand sweating, bringing the gospel to the majority of patients with hand sweating.