Upper thoracic sympathectomy is valuable for patients with vascular occlusive disease and other painful upper extremity diseases. We performed 10 upper thoracic sympahthectomies by percutaneous radiofrequency destruction in painful disorder of upper extremity. Patients were supine and the needle was inserted paratracheally under C-arm fluoroscope. The second and third thoracic sympathetic gangla were destructed by radiofrequency lesion generator. Each lesion was made with a tip temperature of $90^{circ}C$, 90 seconds. Good to excellent results were achieved in all patients without any adverse effect. Seven patients revealed complete sympatholytic effect and other three patients were showen signs of partial sympathetic block. Two patients were persisted sympatholytic effect for 18month in and other 5 patients were persisted sympatholytic effect at present (follow up period: mean 5.8 mon). Percutaneous radiofrequency upper thoracic sympathectomy with anterior paratracheal approach is an effective and a safe method.