Retroperitoneoscopic lumbar sympathectomy successfully combines the advantages of minimally invasive surgery with the effectiveness of the open procedure. Objective: This study aims at evaluating results of retroperitoneal endoscopic lumbar sympathectomy. Methods: Case series report: excision of ganglia L2 - L4 of the lumbar sympathetic chain were performed by retroperitoneal endoscopic access. Results: Thirty patients (100% males) were submitted to retroperitoneal endoscopic lumbar sympathectomy, mean age of 53.5 years (28 - 85).