Primary hand sweating is a functional disorder of the vegetative nerves of unknown origin and is common among young people in Asia, with a higher incidence in women (57.2%). The age of onset is 15-44 years, and the incidence of familial inheritance is as high as 13%. Due to the lack of proper diagnosis and management of sweating, the majority of patients prefer non-surgical treatment measures, including astringents, antiperspirants, sedatives, and anticholinergic drugs, all of which have inaccurate efficacy. With the improvement of endoscopic equipment and special instruments, the advent of television thoracoscopic surgery has revolutionized the treatment of hand sweating. With the improvement of endoscopic equipment and special instruments, the advent of TV thoracoscopic surgery has revolutionized the treatment of hand sweating. TV thoracoscopic thoracic sympathetic nerve trunk dissection for hand sweating is less invasive, safe and reliable, with fewer complications and faster recovery. Hand sweating is the most common indication for thoracic sympathetic nerve chain dissection surgery. The efficiency has been proven to be 95% to 100%. The different methods of T2, T3, and T4 resection or dissection reflect the inconsistent understanding of the innervation of the sweat glands in the palm of the hand. Despite the high efficiency of the above methods, all of them have different degrees of side effects such as excessive dryness of the palm and increased compensatory sweating in other parts of the body after surgery. T3 sympathectomy is mostly used in our hospital, with satisfactory results and fewer and less severe complications. Patients are usually hospitalized for 3 to 4 days without stitch removal, and the short-term observation is now satisfactory with no serious complications.