Bilateral multiple thyroid nodules are a frequent and common disease of the thyroid gland, the incidence of which is increasing year by year and often requires surgical treatment. For bilateral thyroid multiple nodules, total bilateral thyroidectomy is the best treatment because it not only removes existing lesions, but also potential lesions, avoiding the possibility of recurrence or malignancy of residual nodules after surgery, and at the same time, avoiding the risk of needing another surgery due to recurrence of nodules after surgery. However, the only problem with this procedure is the need for lifelong supplemental treatment with thyroxine preparations. This problem is the reason why some patients in China are reluctant to undergo this procedure. However, with reference to the preoperative ultrasound findings, it is possible to preserve some of the normal thyroid tissue for some suitable patients during the operation. This will relieve these patients from the fear of various discomforts after total thyroidectomy and may also enable these patients to avoid the trouble of taking medication for the rest of their lives.