If thyroid cancer metastasizes to lymph nodes around the cervical vessels other than the central group of lymph nodes, cervical lymph node dissection, commonly known as “cervical dissection”, is the most extensive operation in thyroid surgery. The earliest cervical lymph node dissection has been gradually abandoned due to the removal of the internal jugular vein, sternocleidomastoid muscle and paraneoplastic nerve in addition to the lymphatic fatty tissue of the neck, which is too traumatic and has too much impact on the patient’s function. Nowadays, modified cervical lymph node dissection with preservation of the internal jugular vein, sternocleidomastoid muscle and paraneoplastic nerve is mostly used. The modified cervical lymph node dissection can be performed with a “Y”, “X” or “7” shaped incision, but the most commonly used incision is the “L ” incision (Figure 1). Regardless of the incision used, a longitudinal wound is created. Postoperative scar contracture from a longitudinal wound can significantly affect the movement and appearance of the neck. Since thyroid cancer is mostly seen in young and middle-aged women, the appearance of the neck incision is more demanding, therefore, academic experts in China have tried to replace the “L” shaped incision with a large curved low neck incision to improve the impact of cervical lymph node dissection on the patient’s appearance. The controversy of the large low neck incision (Figure 2) is that the incision is too low to achieve complete lymph node dissection. However, with the continuous improvement of surgical skills and knowledge of neck anatomy, at present, the low neck large arc incision can completely achieve the purpose of clearing clean neck lymph nodes and make the incision line and neck skin pattern overlap, which maximally preserves the function and appearance of the neck and improves the patient’s quality of life under the premise of ensuring radical treatment, which is in line with the concept of modern tumor treatment. Meanwhile, for some patients with differentiated thyroid cancer, the cervical plexus can be preserved. This allows the patient to have sensation in the surgical site of the neck, especially in the ear and shoulder, thus avoiding postoperative skin trauma and pain due to the lack of skin sensation in these areas.