Thyroid cancer is the most common malignant tumor of the head and neck, and the most common endocrine malignancy. In recent years, the incidence of thyroid cancer has been on the rise worldwide, especially in China. Since thyroid cancer is often associated with cervical lymph node metastasis, the addition of cervical lymph node dissection after conventional thyroidectomy is an important part of the standard radical thyroid cancer treatment prescribed by the guidelines. The thyroid gland is located directly in front of the neck, and traditional thyroid surgery leaves a 5-10 cm long surgical scar on the neck, although in recent years the sutures are borrowed from cosmetic surgery, individual differences in patient’s skin quality and local inflammatory response still make the scar on the neck unavoidable. In 1998, Shimizu performed a subclavian approach to the thyroid gland. However, because of the lack of natural cavity in the neck, scarless complete lumpectomy thyroid surgery in the neck poses a higher demand on the surgeon’s operating skills. The definition of indications for minimally invasive thyroid surgery is still controversial and is generally limited to benign unilateral thyroid cases. In recent years, based on the development of many difficult procedures such as standard laparoscopic D2 radical treatment of gastric cancer, special hepatic segmental resection, hemihepatectomy, total laparoscopic pancreatic body tail resection with preservation of spleen, total laparoscopic radical treatment of colorectal cancer, etc., further scarless total laparoscopic thyroid surgery in the neck has been carried out, especially for the current high incidence of thyroid cancer with total laparoscopic resection plus central group lymph node dissection. Here we share a case of radical cervical thyroid cancer surgery with scarless total lumpectomy in the neck. The patient, a 31-year-old male, was found to have a thyroid nodule on physical examination, and the ultrasound showed: 11*9.2*8 mm mass in the left upper middle thyroid gland near the outside, growing in a vertical position, with poorly developed borders and dotted strong echogenicity seen inside, proposed US-TI-RADS 4C. Although the patient’s tumor was >1 cm, based on the patient’s age, condition, body type and cosmetic needs, we decided to perform a scarless total lumpectomy of the neck after full communication with the patient. scar total lumpectomy for radical thyroid cancer. The midline approach of total lumpectomy thyroid surgery with Trocar placed through the sternal angle incision is the easiest and most intuitive for the operation, but because the patient is a male, the chest wall tissue is not as free as that of a female, and the skin of the sternal angle incision is close to the sternum, the midline approach may lead to postoperative chest discomfort and the formation of scar bumps on the sternal angle. Therefore, Dr. Qiu Weihua’s team decided to use a more complicated transareolar approach, with three small incisions of 1 cm and 2 0.5 cm in diameter along the patient’s bilateral areolas, and placed the Trocar, which was bluntly separated by the Harmonic ultrasonic knife along the subcutaneous freeing to the cervical region under the broad cervical muscle, and used 6 mmHg of low pressure CO2 to establish the operating space. This approach is similar to a single-port lumpectomy in that all instruments enter through the same pathway and there is no operating triangle between instruments, making the procedure more difficult, but the dissection area is smaller and the patient has good results in terms of aesthetics and quality of life. With the unique magnification of the lumpectomy, the left parathyroid gland, which is only 2 mm in size, was fully and completely explored and protected, while the left recurrent laryngeal nerve, which is <1 mm in diameter, was exposed from the inferior pole of the thyroid gland all the way to its entry into the larynx, thus completely and radically removing the entire left thyroid gland. To achieve radical thyroid cancer surgery, the central group of lymph nodes in the left vi region was further contoured along the slender laryngeal nerve, and the surgery took only 2.5 hours with less than 20 ml of bleeding. The cosmetic results of minimally invasive neck surgery without scarring of the thyroid gland are better compared to traditional surgical approaches. Considering that the high prevalence of thyroid disease is mainly in young and middle-aged women, the presence of neck scars often brings great psychological trauma to patients and affects their normal social interaction activities after surgery. The advent of minimally invasive thyroid surgery has undoubtedly had tremendous psychological and physiological benefits for patients. Some female patients may worry that the transareolar approach will affect the normal function and shape of the breast in the future. In fact, the approach is limited to the subcutaneous area, and the actual tissue trauma, the extent of tissue separation, and the degree of damage to normal tissues, are not significant. Minimally invasive is the current direction of surgical development, and the pursuit of cosmetic results has become one of the important driving forces behind minimally invasive thyroid surgery. The continuous advancement of new endoscopic techniques, new technologies and equipment can be transplanted into thyroid surgery, which can bring more benefits to patients. Based on a large amount of experience in lumpectomy and hundreds of thyroid surgeries every year, we have carried out scarless and completely lumpectomy thyroid surgery in the neck, which has resulted in less damage, faster recovery and satisfactory results compared to traditional surgery.