Objective By long term follow-up study to investigate the curative effect and life quality of video-assisted thoracoscopic T2 sympathetic trunk blocking in the treatment of craniofacial hyperhidrosis. Methods From January 2002 to December 2007, the clinical data of 20 cases were followed up, follow-up with telephone inquiries proceeded every year, the last follow-up time was Junuary 2014, a minimum exceeded five years of follow-up. Results The mean operating time was (37.5±7)min (range,30 to 45 min). Symptoms of craniofacial hyperhidrosis disappeared in all patients. The rates of postoperative compensatory sweating on back and chest were 96.7%, 100%, the other parts of the body like belly and leg had different degrees of compensatory sweating. The rate of satisfaction about operation was 50 percent (10 patients), the rate of general view was 35 percent (7 patients), the rate of dissatisfaction was 15 percent (3 patients). The postoperative quality of life got “obvious better” in 9 patients (45 percent), “better” in 8 patients (40 percent), “no better” in 3 patients (15 percent). Conclusions Endoscopic thoracic of T₂ sympathetic trunk blocking for craniofacial hyperhidrosis is effective. The operation improves patients’ quality of life and gives satisfactory outcomes, But, all patients should be informed of compensatory hyperhidrosis before performing the operation.