Lumbar sympathectomy (LS) has been used in the treatment of various vascular and neurological disorders of lower extremities. lumbar sympathectomy is a safe and effective procedure for patients with advanced Buerger’s disease requiring lumbar sympathectomy. It has a short convalescent time with minimal morbidity. It appears to be a viable alternative to open procedures. Besides, Retroperitoneoscopic resection of the lower lumbar sympathetic trunk is a safe and effective procedure for obtaining suspension of excessive sweat secretion in patients with plantar hyperhidrosis that cannot be treated with conservative methods.