There were 51 patients (28 male, 23 female) underwent the endoscopic thoracic sympathectomy for palmar hyperhidrosis with mean age of 19.9 years (11-42). Palmar, plantar and palmar, axillar, plantar sweating was in 17 (33.3 percent) and 33 (64.7 percent) respectively. Under general anesthesia with single lumen tracheal intubation, semi- fowler position, the arms was extended slightly upward. The instruments is of needle scope. The technique: selective 13 sympathectomy of 1.5cm distance by electrocautery. Results: mean operative time was 10.5 minutes (l0-25). No need of drainage. There was not any complication like pneumothorax, Horner's syndrome. Dry hands were in 51 (100 percent) including 46 (91.2 percent) of normal hand, 5 (9.8 percent) of over dryness. Axillar sweating was cured or decreased in 21 cases (41.1 percent) and plantar sweating in 42 cases (82.4 percent). The compensatory sweating of the back and of the breast, abdomen area are in 38 cases (74.5 percent) and 41 cases (80.4 percent) respectively. All of patients are satisfied. Conclusion: Selective T3 sympathectomy by needle scope may be a procedure of choice for treatment of hyperhidrosis with 100 percent dryhand, very low overdryness rate and the compensatory sweating is in acceptable limit.