With the advancement of surgical technology, modern surgery takes the maximum psychological and physiological recovery of the patient after treatment as the ultimate goal of treatment, in order to minimize the physical and mental pain brought by surgery in the near and distant future. Clinical application has proved that endoscopic thyroid surgery is safe and feasible, relatively beautiful, and satisfies modern people’s pursuit of beauty. Endoscopic thyroid surgery is divided into two kinds of completely endoscopic and endoscopic-assisted surgery; surgical access is divided into thoracic breast approach (single hole, two holes, three holes), chest wall approach, axillary approach, subclavian approach, Miccoli, robotic surgery, etc.; among them, the areola approach (gas-injection surgery) is the most cosmetic, but traumatized (path far), difficult to operate; the least traumatic is Miccoli surgery (non-gas-injection surgery) It is cosmetically minimally invasive, easy to perform, has a wide range of indications, and has a smaller scar. Indications for endoscopic thyroid surgery: healthy patients; non-malignant tumors, diameter £ 3-4cm; non-diffusely enlarged thyroid; indications for T3, T4, FNA, ultrasound, CT examination. Contraindications: possible malignancy; history of neck surgery; history of neck radiotherapy; local infection, inflammation, or burns; recent intracapsular hemorrhage. The basic techniques of endoscopic thyroid surgery: 1, the establishment of surgical space: closed and open method; 2, endoscopic hemostasis: electrocoagulation hemostasis, titanium clips, ultrasonic knife and suture, etc.; 3, endoscopic tissue separation: it is an important step, good separation, clear anatomy, less bleeding, otherwise cause tissue damage; tissue separation and incision methods: electrocoagulation cutting, scissors sharp cutting, ultrasonic knife coagulation cutting, separation forceps blunt Separation, etc. Surgical complications: bleeding equivalent to open surgery, gas embolism, flap injury, thyroid ectopic implantation. Future development of minimally invasive surgery: Minimally invasive surgery is a transitional stage from invasive surgery to non-invasive surgery, which will eventually be replaced by genetic and physical treatments. Computerized instrumented surgery will be another important stage in the development of minimally invasive surgery. Simulation will become an important stage in the clinical training of minimally invasive surgeons.