The author first recalls the origins of the words "sympathetic" and "neurovegetative system" and then outlines the beginnings of surgery on the autonomic nervous system in general. This started with the section of the rami communicantes introduced by the Australians Royle and Hunter in surgery of the muscle tone. Then nearly at the same time in 1924. Adson in USA and J. Diez in Argentina resected the lumbar sympathetic chains; the latter mainly for treatment of thromboangeitis obliterans. From 1924 on, lumbar sympathectomy met with rapid success as shown at the Cairo Congress of 1935. Physiologic and pathologic effects of lumbar sympathectomy are analysed and the usual techniques are reviewed. The author then lists the specific postoperative complications, including the pain symdroms and the functional sexual disorders in males. Finally the principal indications where lumbar sympathectomy proved useful are named. Chronic obliterative arteriopathies are the first. For these lumbar sympathectomy still holds a palliative, supportive or absolute role. A scheme illustrates its beneficial actions.