Primary hand sweating is a syndrome in which the sympathetic nerves that innervate the sweat glands in the hands are abnormally excited, resulting in abnormal hypersecretion of sweat glands in the hands that are not affected by external temperature. Primary hand sweating has no effect on human health, but it often affects the life, work and social life of the patient. The main symptoms are cold, moist and sweaty palms, which are exacerbated by stress and mood swings, and even dripping sweat, seriously affecting the patient’s school, work, life and mental health. At present, although there are many treatment methods, most of them are not effective, and thoracoscopic (minimally invasive) thoracic sympathectomy is the only effective method for treating hand sweating. （The degree of excessive sweating (of the hands) is graded. Mild (moist palms); moderate (sweaty palms soaking through 1 handkerchief); severe (sweaty palms in the form of dripping beads). Secondary hyperhidrosis caused by hyperthyroidism or other diseases needs to be excluded. Minimally invasive surgery can be used to treat hand sweating if the severity of hand sweating is moderate or above, or if the sweating symptoms affect daily life. The complications of surgery are mainly compensatory hyperhidrosis in other parts of the body. The post-operative compensatory hyperhidrosis classification criteria refer to: mild: increased sweating of the torso, but underwear is still dry; moderate: sweating sometimes soaked underwear, but still tolerable; severe: a lot of sweating soaked underwear, sometimes need to change more than one day, seriously affecting the patient’s daily life, intolerable. However, the results of 1000 postoperative follow-up cases showed that 92.93% (749/806) of the postoperative follow-up patients had a significantly improved quality of life compared to the preoperative period, 5.71% (46/806) had no significant improvement, and 1.36% (11/806) had a worse quality of life. The innervated nerves of the palmar sweat glands originate from the upper thoracic segment of the spinal cord (T1-L5), and single-port method thoracoscopic thoracic sympathetic trunk T3 or T3-4 dissection (minimally invasive) is safe and effective for the treatment of primary hand sweating, with less trauma and shorter hospital stay.