Primary hyperhidrosis is a condition characterized by excessive sweating. The estimated prevalence is between 0.6 and 4.4%, and it can have economic, psychological, and social consequences for affected individuals. Family and genetic studies have suggested a genetic component in the inheritance of the disease. In this review, we summarize the current literature on genetic disposition to primary hyperhidrosis. We Identified 20 studies on Pubmed and Embase in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Probands reported a positive family history in 5.7–65% of cases, and the inheritance appeared to be either autosomal dominant or recessive. Individuals with palmoplantar phenotypes and a positive family history had a younger age of onset. Genetic linkage and genome-wide association studies have identified loci on chromosome 2, 14, and 16. However, the evidence is heterogeneous and limited. It seems that primary hyperhidrosis is polygenically inherited, and considering the impairment, further data to understand the genetic etiology of the disease are needed.