At present, the incidence of thyroid cancer is rapidly increasing due to the influence of hormones in diet, electromagnetic radiation in life, accelerated pace of life and mental tension. On the other hand, due to the popularity of high-resolution color ultrasound, many patients with early stage papillary carcinoma can be diagnosed. Therefore, thyroid surgeons generally feel that the current volume of thyroid cancer surgeries is rising sharply, and in common parlance, “it’s too much to do!” . There is still a controversy regarding the surgical approach to thyroid cancer, and each side has its own arguments. The controversy lies in patients with unilateral lesions. Overseas, the European and American view is that total excision is the mainstay, while a few American hospitals sometimes use lobectomy with isthmus for lesions smaller than 1 cm (or 1-2 cm), preserving part of the gland. Domestic procedures are currently varied, but can be divided into two categories, one using glandular lobes plus isthmus or contralateral sections; some total resections. The author advocates total resection for patients with one of the following high-risk factors: age older than 45 years, malignancy confirmed on one side/nodules found on the other side by ultrasound, positive lymph node metastasis in the lateral cervical region, tumor invasion of the envelope, tumor diameter greater than 3 cm, possibility of distant metastatic lesions, thyroid cancer in children, follicular carcinoma. Young men and women who have not had any children, with unilateral tumor of 1-2 cm in diameter and no lymph node metastasis in the cervical area can undergo surgery to preserve one lobe of the gland, but clearing the lymph nodes in the tracheoesophageal groove on the same side is sufficient. Because thyroid surgery is very safe nowadays, the rate of laryngeal nerve damage and parathyroid low incidence are low, and papillary carcinoma develops slowly, so it is a reasonable choice to preserve one side of the gland and save it for another surgery in the future. The probability of collateral line increases.