The indicators for thyroid surgery are not that surgery is necessary if the thyroid gland reaches grade 3 or above. It depends on whether the enlarged thyroid gland is benign, paying close attention to the rate of thyroid growth and the location of the compression. If it reaches grade 3, it can be controlled and cured with active treatment, but it is important to pay attention to the fact that further development may lead to a malignant lesion. The indicators for surgery must be an adverse reaction to antithyroid drugs, rough and irregular borders of the enlarged thyroid gland, compression of the esophagus and trachea, positive tumor marker tests for abnormal thyroid function, and timely resuscitation of thyroid crisis. Surgery is not recommended for the elderly, and conservative treatment is possible. Grade 3 should be reviewed regularly or a biopsy should be done, and a biopsy must be performed when it reaches grade 4. In addition to the necessary drug control, acupuncture and Chinese herbal medicine can be performed with significant effect.