Surgery for thyroid nodules may be considered in the following cases: (1) when there are local pressure symptoms associated with the nodule; (2) when there is a combination of hyperthyroidism and medical treatment has failed; (3) when the mass is located in the posterior sternum or mediastinum; (4) when the nodule grows progressively and is clinically considered to have a malignant tendency 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-Ι incisional approaches. After surgical treatment, the occurrence of surgical complications (e.g., bleeding, infection, injury to the recurrent laryngeal nerve, 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 thereafter thyroid function should be monitored regularly 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. After benign thyroid nodules surgery, TSH suppressive therapy is not recommended to prevent nodule recurrence.