Hand sweating is a disease caused by exocrine glands that cause excessive sweating, although the cause is not harmful to health, but because the palms of the hands, soles and armpits sweating, and sometimes the head, neck, trunk, groin or perineum are also prone to sweating. The sweating is often dripping and can cause embarrassment and hindrance to life and work or social interaction. Non-surgical treatments include astringents, antiperspirants, sedatives, anticholinergic drugs, hypnotherapy, psychotherapy, ECT, and acupuncture, all of which have no clear efficacy except for anticholinergic drugs, but their use is limited by their side effects. Thoracic sympathectomy is currently the only effective and long-lasting treatment for hand sweating. However, previous procedures have been either very invasive or potentially dangerous, making them difficult for patients to undergo. TV-assisted thoracoscopic thoracic sympathectomy is less invasive, reveals the thoracic sympathetic nerve well, is accurately positioned, is safe and reliable, has a rapid postoperative recovery, has a definite and long-lasting effect, can be done bilaterally in the same position, is minimally invasive and is readily accepted by patients. The effect is exact and satisfactory, and the incidence of compensatory hyperhidrosis is low.