Thyroid cancer is insensitive to both radiotherapy and chemotherapy, especially for differentiated thyroid cancer, and the efficiency is almost zero. Therefore, the main treatment for thyroid cancer in children is surgery. In general, the majority of thyroid cancers have good surgical results. However, a proper surgical plan should be formulated to minimize the chance of recurrence or metastasis after surgery and to avoid reoperation. There are several common types of thyroid cancer in children. For papillary thyroid cancer, if the tumor is small, confined to the unilateral thyroid lobe, not invading the envelope, without lymph nodes and distant metastasis, unilateral lobectomy with isthmus can be performed, and the lymph nodes in the anterior trachea and tracheoesophageal groove on the affected side can be cleared at the same time. If the tumor extends to the isthmus, involves the thyroid gland bilaterally, involves the thyroid envelope, and involves the surrounding tissues, especially if there are lymph node metastases and/or distant metastases, total thyroidectomy and lymph node dissection in the central region should be performed. However, caution should be exercised during surgery. Routine dissection of the recurrent laryngeal nerve and familiarity with the site and morphology of the parathyroid gland should be performed to avoid misincision. Since the recurrent laryngeal nerve and parathyroid glands in children are much smaller than those in adults, care should be taken to identify and protect them during surgery to avoid discomfort such as hoarseness, choking on water, breathing difficulties and convulsions, which can seriously affect the quality of life of children. Since papillary thyroid cancer is prone to lymph node metastasis, and usually metastasizes to the VI area, i.e. tracheoesophageal groove first, the metastasis rate is about 80%. Therefore, the tracheoesophageal sulcus is usually routinely cleared during thyroid cancer surgery. If there is metastasis in the lateral cervical lymph nodes before surgery, unilateral or bilateral cervical lymph node dissection should be performed according to the metastasis status. When performing lateral cervical lymph node dissection, care should be taken to clean the metastatic lymph nodes and other diseased tissues while minimizing unnecessary damage. In addition to the conventional three preserved sternocleidomastoid muscle, internal jugular vein, and vagus nerve, many skilled and experienced head and neck surgeons have been able to perform seven preserved sternocleidomastoid muscle, internal jugular vein, and vagus nerve, in addition to the paramedian nerve, cervical plexus skin branch, scapulolingual muscle, and external jugular vein. To minimize inadvertent injury, if the lymph nodes in area I are truly not enlarged, they may not be dissected. Some parents are concerned that the lymph nodes are the main immune organs, so will they affect the future health of their children? Parents should not be anxious about this. The main purpose of cervical dissection is to remove metastatic cervical lymph nodes and does not affect the immune function of the child. This is because for children and adolescents, their main immune organs are structures such as the thymus and bone marrow. Having practiced medicine for 30 years, I have found that the aesthetics of the postoperative wound also has a very important impact on the quality of life of the child after recovery. Therefore, I pay special attention to aesthetics. When performing cervical debridement, I avoid making a longitudinal incision with a vertical skin line and make a transverse incision at the root of the neck following the skin line whenever possible. In this way, after surgery, the child can use the collar to completely cover the surgical scars and minimize the negative psychological effects. Although follicular carcinoma of the thyroid gland is of low malignancy, blood metastasis can occur at an early stage, so even if the carcinoma is still confined to one side of the gland, total thyroidectomy should be performed. For those with lymph node metastasis, cervical lymph node dissection should be performed. Medullary thyroid carcinoma is of medium malignancy and often has cervical lymph node metastasis, so total thyroidectomy with cervical lymph node dissection is often recommended. For undifferentiated carcinoma, with high malignancy and rapid development, surgery is generally not recommended, and radiotherapy and chemotherapy are feasible.