Nearly 3% of the population has hyperhidrosis. Quality of life is affected, impacting on social relationships and professional activity, and social anxiety disorder can sometime develop. We review the definition and causes of hyperhidrosis and the clinical evaluation of patients. After describing the different clinical aspects of the condition, we discuss the medical and surgical treatments. Of such treatments currently available, particular mention is made of the use of botulinum toxin in some forms of hyperhidrosis as an intermediate option between the traditional treatments and surgery. We also draw attention to the use of minimal access surgical techniques (videothoracoscopy), which, over the past decade, have become established as an effective, safe, and permanent approach for the treatment of hyperhidrosis when indicated.