Introduction/Objective. Primary focal hyperhidrosis (PFH) is an idiopathic condition where excessive sweating affects one or more body regions, including axillae, palms, soles, and/or face. Most studies on quality-of-life focus on the period up to one year after bilateral thoracoscopic sympathectomy (BTS). This study aims to determine the 10-year trend in quality of life among patients from the Republic of Serbia with palmar-plantar-axillary primary focal hyperhidrosis, treated with BTS at the R3-R4 level. A secondary goal is to ascertain the existence of compensatory sweating. Methods. All patients underwent a standardized BTS in a single act, through the cutting of ganglia with ultrasonic scissors at the R3-R4 level. For data collection, patients completed the "Hyperhidrosis Quality of Life Questionnaire (HQLQ)," and the Hyperhidrosis Disease Severity Scale (HDSS), preoperatively, postoperatively within 30 days, and 10 years after BTS. Results. The total sample consisted of 103 subjects who completed all three questionnaires. Considering the improvement in Quality of Life (QoL) from the group excellent, good, and average, the postoperative improvement was immediately postoperative in 88.4% of patients, while in the ten-year period, it was 87.4%. No statistically significant differences were found between the assessment of life satisfaction after 30 days and 10 years after BTS. Out of the total number of operated patients, two patients (1.94%) characterized their compensatory sweating as very pronounced. Conclusion. After 10 years from BTS, the QoL remains at an exceptionally high level, with an annual trend of decline of about 0.1%.