Nodular goiter is the most common benign clinical nodular lesion of the thyroid gland, often multiple, distributed throughout the thyroid gland, varying in size, and may become cystic in oversized cases, with the nodules usually having no or incomplete envelope. Most nodular goiters do not require specific treatment and are only followed up periodically. Surgery may be considered in the following cases: 1. Local pressure symptoms associated with the nodule are apparent. 2. When the nodule is combined with hyperthyroidism and medical treatment is not effective. 3. Larger nodules located in the posterior sternum or superior mediastinum, prone to airway compression, clinically known as retrosternal goiter. 4. If the nodule grows progressively and malignancy is clinically suspected or combined with high risk factors for thyroid cancer. 5. If the nodule affects the appearance or becomes a serious ideological concern for the patient and affects normal life, it can also be a relative indication for surgery. The surgical procedure for nodular goiter is usually performed by removing the affected lobe or the lobe on the side with larger nodules and suspected cancer. While the nodule is completely removed, the normal thyroid tissue should be preserved as much as possible. Total or near-total thyroidectomy is generally not used unless both lobes have diffusely distributed nodules with obvious symptoms or nodules suspected of being cancerous. Endoscopic thyroid surgery can be used for benign thyroid nodules because it has no surgical incision in the exposed area of the neck, no scar production, and better cosmetic results. The surgical pathways include endoscopically assisted small sternotomy incisions and subclavian incisions, as well as fully lumpectoscopic areolar incision pathways that require gas injection, axillary transaxillary pathways, and anterior thoracic pathways. However, lumpectomy thyroid surgery is not a minimally invasive procedure and should be carefully selected according to the patient’s wishes. Ultrasound-guided percutaneous anhydrous ethanol injection can be used for simple cystic and largely liquefied thyroid nodules, and percutaneous laser ablation or radiofrequency ablation can be used for some benign nodules. However, the indications should be strictly controlled and the possibility of malignant nodules should be excluded before treatment.