The main symptom of hand sweating is severe sweating of the upper extremities, which affects work and writing. The traditional treatment is open thoracic sympathectomy, but the special treatment of our department is thoracoscopic thoracic sympathectomy, in which there are only three small keyhole-like holes in the chest wall, so the patient has little trauma, quick recovery, no large incisions in the chest wall and beautiful. Hand sweating is a disease caused by exocrine glands that cause excessive sweating, although the cause is not a major health concern, but due to sweaty palms, soles and armpits, sometimes the head, neck, trunk, groin or perineum are also prone to excessive sweating. The sweating is often dripping and can cause embarrassment and hindrance to life and work or social life. The principle of surgery is to cut off the thoracic sympathetic ganglion, which relieves the sympathetic nerve from innervating the epidermal sweat glands and significantly reduces sweat secretion, thus treating hyperhidrosis. In the past, this type of surgery used a traditional incision, which was more traumatic and resulted in more losses than gains, so surgery is no longer a common treatment method. The minimally invasive nature of thoracoscopy has led to a renewed acceptance of thoracic sympathectomy and its popularity. Thoracoscopic treatment of hand sweating involves making only three small keyhole incisions in the chest wall and electrocautery of the thoracic sympathetic ganglion to reduce sweat production in the epigastrium. The procedure is effective and safe, with minimal trauma and quick recovery, and the patient can return to school and work in 3 to 5 days.