Most benign thyroid nodules require only regular follow-up and no specific treatment. In a few cases, surgery, TSH suppression therapy, radioactive iodine, or 131I, or other treatment options are available. Surgery may be considered for thyroid nodules in the following cases: 1. The presence of local pressure symptoms clearly associated with the nodule; 2. The combination of hyperthyroidism, where medical treatment is ineffective; 3. The mass is located in the posterior sternum or mediastinum; 4. Progressive growth of the nodule: clinical consideration of a predisposition to malignancy or a combination of high-risk factors for thyroid cancer. Those who strongly request surgery because of appearance or excessive ideological concerns affecting normal life can be considered as relative indications for surgery. The principle of surgery for benign thyroid nodules is: complete removal of thyroid nodules while preserving as much normal thyroid tissue as possible. The use of total/near-total thyroidectomy is recommended with caution. The latter is indicated for nodules that are diffusely distributed bilaterally in the thyroid gland, making it difficult to preserve more normal thyroid tissue intraoperatively. Intraoperative care should be taken to protect the parathyroid glands and the recurrent laryngeal nerve. Endoscopic thyroid surgery can be one of the surgical options for benign thyroid nodules because of its good postoperative appearance. Surgical approaches include suprasternal, subclavian, anterior chest wall, axillary, and other approaches. It is recommended that the surgical approach be chosen in a way that minimizes trauma and avoids non-class I incisional approaches. After surgical treatment, the occurrence of surgical complications (e.g., bleeding, infection, laryngeal nerve injury, parathyroid gland injury, etc.) should be observed. If the operator has extensive experience in thyroid surgery (more than 100 thyroid surgeries per year), the incidence of complications will be significantly lower. Because some or all of the thyroid tissue is removed, patients are at risk of postoperative hypothyroidism (hypothyroidism) of varying degrees, and those with high titers of thyroid peroxidase antibodies (TPOAb) and/or thyroglobulin antibodies (TgAb) are more likely to develop hypothyroidism. For those who undergo total thyroidectomy, levothyroxine (L-T4) replacement therapy should be started immediately after surgery and thyroid function should be monitored regularly thereafter to keep TSH levels in the normal range; for those who keep part of the thyroid gland, thyroid function should also be monitored regularly after surgery (the first test is 1 month after surgery), and L-T4 replacement therapy should be given promptly if hypothyroidism is detected during monitoring. TSH suppressive therapy is not recommended to prevent recurrence of nodules after surgery for benign thyroid nodules.