he result of our study concludes that the single-port VATS sympathectomy for palmer hyperhidrosis in supine decubitus position through areolar incision in male and sub mammary incision in female is safe, more cosmetic, reliable and feasible method for management of palmer hyperhidrosis, and associated with less intraoperative time, low morbidity and a short hospital stay. VATS sympathectomy through large sized single port (10 mm) with one lung ventilation making the procedure reliable ,easy , quick and less complications.