Introduction: Palmer hydrosis may cause many troubles to the patients. many modalities of treatment were used. Patient and methods: Eighty patients complaining of bilateral severe hyperhidrosis in the palmar area and axillary region. Our analysis of 40 bilateral thoracoscopicsympathectomies and 20 patients had radiofrequency ablation and 20 patients had other medical treatment. Aim: To evaluate the end results of surgical intervention and time of intervention in severe cases of hyperhidrosis in comparison with others methods. Results: The incidence of CS after surgery was 6 patients (15%) and this compared RF that was one patient (5%). Also these symptoms were relived within 6 months follow up. No Horner or transient Horner had been reported with both intervention methods. Conclusion: RFT is effective treatment for palmar and axillary hyperhydrosis that provide immediate and long-term success rate with a little complication, simple and with recurrence rate 2.5%. Key words:- Hyperhydrosis sympathectomy radiofrequency ablation