Thoracoscopic syrnpathicotomy is effective in treating not only palmar hyperhidrosis, but, also in treating axillary hyperhidrosis. In previous studies in Korea, sympathicotomy was focused on combinations including the End to 4th sympathetic chains (R2, 3, 4). Using a minimally invasive technique, the results of sympathicotomy of the 4th and 5th chains (R4, 5) of five patients, from February to August, 2002, for axillary hyperhidrosis without osmidrosis, were reviewed. All patients had a successful operation, their profuse sweating ceased. Three patients suffered from some degree of compensatory sweating. Among the three patients, only one patient suffered from moderate compensatory sweating over his back and thighs. Thoracoscopic R4, 5 sympathicotomy offers a very appealing method in the treatment for axillary hyperhidrosis in patients who have profuse axillary sweating.