Objective：To study the effect of exposure of recurrent laryngeal nerve(RLN) in prevention of RLN injury during thyroid surgery under general anesthesia. 
Methods：The clinical data of 389 patients who underwent thyroid operations under general anesthesia were retrospectively reviewed. The RLN was exposed in 163 cases and was not exposed in 226 cases. 
Results：Two cases (1.10%) suffered from temporary RLN injury in exposure group and 12 cases (5.30%) suffered from RLN injury in non-exposure group (temporary nerve injury in 7 cases and permanent nerve injury in 5 cases)(P＜0. 05).
Conclusions：Exposure of RLN can greatly decrease the RLN injury rate in thyroid surgery under general anesthesia.