Abstract: Thoracic sympathetic procedure is an effective method to treat many sympathetic nerve-related diseases. Currently the procedure is usually used to treat hyperhidrosis (palmar and plantar hyperhidrosis, craniofacial hyperhidrosis, axillary hyperhidrosis etc.) and facial blushing. In 1920, Kotzareff became the first one who applied thoracic sympathectomy to treat palmar and plantar hyperhidrosis and succeed. Nowadays, the conventional Endoscopic Thoracic Sympathetic procedures (ETS) are adopted by most thoracic surgeons. In recent years, this surgery has been further improved; some scholars proposed own procedures. Regarding this, the article made summary and discussion on various ways of thoracic sympathetic procedures.