The authors present a group of 48 thoracoscopic thoracic sympathectomies they performed in 35 patients between November 1997 and March 2000. A favourable effect was recorded in all operated patients where the defect healed or the blood supply of the upper extremities improved. Twice thoracoscopic resympathectomy was performed in a patient 15 years after classical upper thoracic sympathectomy [2] from the supraclavicular space. Twice a relapse was recorded one year after the operation. The complaints are substantially smaller than before operation. The authors emphasize the advantages of thoracoscopic thoracic sympathectomy which is associated with a minimal risk of complications.