Comparative analysis of thoracic sympathectomy efficacy, performed for Raynaud's phenomenon (RP), was accomplished, concerning application either endoscopic or open method. In 62 patients, suffering RP, open or endoscopic thoracic sympathectomy was done in surgical and vascular departments in 1997-2007 yrs. In 32 (51.61%) patients there was performed endoscopic thoracic sympathectomy, in 30 (48.39%)--upper thoracic sympathectomy, using extrapleural supraclavicular access, according to V. N. Klimenko. Immediate results of upper thoracic sympathectomy did not differ trustworthy depending on any method or access. Late follow-up results of upper thoracic sympathectomy were worse than immediate results by 28%--in endoscopic variant and by 43% --in the open one. The positive results rate after endoscopic thoracic sympathectomy have exceeded that after conducting the open one by 15.18%.