The vast majority of hoarseness after thyroid surgery is due to intraoperative damage to the recurrent laryngeal nerve, but can also be due to rare causes: inflammatory swelling of the vocal cords due to general anesthesia tracheal intubation, vocal cord abrasions, and dislocation of the arytenoid cartilage, which cause postoperative vocal cord movement disorders and symptoms of hoarseness. Patients with laryngeal recurrent nerve injury usually have posterior vocal fold paralysis, which will affect the quality of life of patients to varying degrees. In case of inflammatory swelling and vocal fold abrasion, anti-inflammatory treatment and nebulized inhalation can be given, and hoarseness can generally be recovered after one week. For arytenoid cartilage dislocation, arytenoid cartilage repositioning can be performed under surface anesthesia or general anesthesia with a suitable laryngeal forceps and laryngoscopic support, which is the most ideal treatment method at present. As long as the arytenoid cartilage is repositioned accurately, the vocal cord movement will soon return to normal. If the hoarseness after thyroid surgery is caused by damage to the recurrent laryngeal nerve, a clinical distinction should be made between permanent and temporary. Temporary injury to the recurrent laryngeal nerve is often due to intraoperative clamping of the recurrent laryngeal nerve, excessive stretching, and ischemic edema of the nerve due to excessive dissection of the recurrent laryngeal nerve. Temporary laryngeal nerve injury can be treated symptomatically with neurotrophic drugs, such as vitamin B1 and B12, under the guidance of a physician, and hoarseness can generally be restored within 3 months after surgery. The most common cause of permanent laryngeal nerve injury caused by thyroid surgery is inadvertent severance of the laryngeal nerve during surgery or blind ligation or suturing of the laryngeal nerve to stop bleeding during surgery.