Objective: To assess the feasibility and safety of total endoscopic thyroidectomy via bilateral axillary and ipsilateral breast approach (BAIBA). Methods: The data of 35 patients with thyroid diseases who underwent BAIBA endoscopic thyroidectomy performed by the same surgeon between April 2010 and March 2012 were analyzed, and the surgical procedures were described. Results: Operations were successfully completed in all the 35 patients without conversion to open surgery. The average operative time was (126±26.3) min, intraoperative blood loss was (15.3±3.49) mL and mean size of the skin flap was (118.6±8.74) cm2. No postoperative complication occurred, and postoperative drainage volume on day 1 was (89.5±62.36) mL. The average length of postoperative hospital stay was 2–3 d and the postoperative pain score was 0–2. Follow-up ranged from 4 to 20 months; no recurrence was noted and the cosmetic results were satisfactory. Conclusion: BAIBA endoscopic thyroidectomy is safe and feasible, and it has the advantages of excellent cosmetic outcome, less pain, and quick recovery.