Introduction: Primary axillary hyperhidrosis (PAH) is a distressing condition that can pose significant social embarrassment. Different treatments such as topical agents, systemic agentsand botulinum toxin are only temporarily effective. Thus, there is a need for evidence-based management. The following study describes a new technique for the management of (PAH). We study the efficacy and safety of the subdermal application of two different diode lasers, at 980 nm or 1470 nm, for ablation of the sweat glands versus intradermal Botulinum toxin A (BTA). Patients and Methods: This parallel-randomized controlled pilot study was conducted upon 90 PAH patients from December-2019 to July-2021 at the National Institute of Laser Enhanced Sciences (NILES), Egypt; the diode laser 980 nm group (30 cases), the diode laser 1470 nm group (30 cases) and the BTA group (30 cases). Results: The three groups were comparable regarding age, BMI, and gender. The laser groups had higher reductions of HDSS score than the BTA group at 1-month 1.37__ampersandsignplusmn;0.49 and 1.20__ampersandsignplusmn;0.41 versus 2.03__ampersandsignplusmn;0.67 for the laser 980,1470 and the BTA groups, respectively (p values __ampersandsignlt; 0.001) and at 6-months (1.37__ampersandsignplusmn;0.48 and 1.20__ampersandsignplusmn;0.41 versus 2.20__ampersandsignplusmn;0.55; p-value __ampersandsignlt; 0.001). At 1-month and 6-months, the laser groups had higher reduction of mean moisture percentages than the BTA group at 1-month with 49.34__ampersandsignplusmn;5.88% and 48.93__ampersandsignplusmn;6.62% versus 55.89__ampersandsignplusmn;9.20%, respectively (p-values 0.003 __ampersandsignamp; 0.001) and at 6-months 49.42__ampersandsignplusmn;6.32% and 48.90__ampersandsignplusmn;6.79% versus 56.21__ampersandsignplusmn;7.98%, respectively (p-values 0.001 __ampersandsignamp;__ampersandsignlt; 0.001). At 1-month and month-6, there was a higher patient satisfaction in the laser groups than in the BTA group (p-values __ampersandsignlt; 0.05). The laser groups demonstrated better GAIS score than the BTA group at both 1-month (p-values __ampersandsignlt; 0.05) and 6-months visits (p-values__ampersandsignlt; 0.001). Conclusion: The study showed that Diode laser 1470 nm is safer and more effective treatment for PAH than Diode laser 980 nm.