Sweating is a physiological process of the body’s metabolism that regulates body temperature and excretes waste. However, if excessive sweating occurs, pathological hyperhidrosis is formed, which is known as hyperhidrosis. According to the cause of the disease, it is divided into primary hyperhidrosis and secondary hyperhidrosis; according to the scope of the disease, it is divided into generalized hyperhidrosis and localized hyperhidrosis. Here we mainly introduce the primary local hyperhidrosis, that is, primary hand sweating, which is a kind of hyperhidrosis caused by hypersecretion of sweat glands in the hand, the patient mostly has symptoms since childhood, and it is more serious in puberty, which is mainly manifested as sweaty palms, and the sweating is mental sweating, which is not related to thermoregulation. Patients have their own fixed stimulus aggravating factors, such as: emotional excitement, nervousness, grief, anger, anxiety and high temperature environment when sweating intensified, sweating such as drops of beads. Some patients are accompanied by excessive sweating on the soles of the feet and in the armpits. Although there is no great harm to physical health, but the sweat dripping more than, to life, work and social interaction brings a lot of inconvenience and embarrassment, resulting in its psychosocial pressure and impede its normal life, it can lead to patients with long-term distress, and even depression. The pathogenesis of primary hand sweating is still unclear. At present, it is generally believed that it is a kind of vegetative nerve dysfunction disease, mainly due to the patient’s sympathetic nerve is more sensitive than normal and intense reaction caused by the sympathetic nerve overexcitation disease. Sympathetic nerves play a role in controlling the secretion of sweat, and the sympathetic nerves of patients with hyperhidrosis are more sensitive than normal, and easily stimulated, so that the secretion of sweat of patients will be relatively exuberant. According to relevant reports, the incidence of primary hyperhidrosis is 0.5%~2.8%, and according to the severity of hand sweating, it is divided into 3 degrees: mild, sweaty palms are moist; moderate, sweaty palms are soaked through a handkerchief; and severe, sweaty palms are dripping beads. The diagnostic criteria for primary hyperhidrosis are: limited palpable hyperhidrosis lasting for at least 6 months without obvious trigger, and accompanied by two or more of the following features: 1) the appearance of bilateral or relatively symmetrical hyperhidrosis; 2) at least one episode per week or more; 3) hyperhidrosis interfering with daily activities; 4) age of onset <25 years old; 5) family history; and 6) absence of symptoms of hyperhidrosis during sleep. Treatment: 1, non-surgical treatment of hyperhidrosis: short-lived effect, can not be cured, and there are obvious side effects. 2. Thoracoscopic sympathetic ganglion chain amputation for the treatment of hyperhidrosis has become the most effective treatment for hyperhidrosis because of its precise efficacy, small trauma, fast recovery and few complications. Two 0.5cm surgical incisions in each armpit can be completed, and the whole operation time is about 30 minutes. The cure rate of hand sweating after the surgery is more than 98%, and the cure rate of foot sweating is 80%. If there is a history of pleurisy or pneumonia, patients with serious pleural adhesions should be cautious in this surgery. Surgical complications: recent postoperative complications such as pneumothorax, subcutaneous emphysema, hemothorax, chest pain, intercostal neuralgia. Long-term post-surgical complications mainly include: (1) palms are easily chapped in winter, which is mainly related to the dryness of the palms without sweating after the operation, and the symptoms can be alleviated by applying moisturizing cosmetics; (2) Horner's syndrome, which manifests itself as drooping eyelids, sunken eyes, and shrinking pupils, is one of the most serious complications after sympathectomy, which is mainly caused by the damage to the stellate ganglion. (3) Compensatory hyperhidrosis: it refers to the increase of sweating in other parts of the body after the operation compared with that before the operation. According to the degree of compensatory hyperhidrosis after the operation, it can be divided into three degrees: mild, the body sweats more, but the underwear is dry; moderate, the sweating is sometimes soaked with underwear, but it can be tolerated; severe, the large amount of sweat soaked through the underwear, which affects the daily life seriously and cannot be tolerated. Compensatory sweating is mostly found on the chest and back, followed by thighs, abdomen, calves, buttocks, head, armpits and soles. The incidence and degree of postoperative compensatory sweating is related to the segment and extent of sympathetic trunk processing; the more segments and the greater the extent, the more chance of occurrence or the more severe the degree. Reducing the extent of sympathetic trunk severance may reduce the incidence and degree of postoperative compensatory sweating, as well as the incidence of postoperative chafing of the hand. The disease has no tendency to heal spontaneously, and the symptoms gradually worsen with growth and development. The incidence of postoperative compensatory hyperhidrosis is 3.6 times higher in adults than in minors who undergo surgery, and the older the patient, the greater the likelihood of pleural adhesions, so it is recommended to undergo surgery as early as possible.