Better exposure and protection of recurrent laryngeal nerve (RLN) are critical to ensure the quality and safety of thyroid surgery. The temporary or permanent RLN injury during or after operation caused by anatomical variations of the RLN and iatrogenic damage may affect the patients’ quality of life and the prognosis of the disease. Here, the authors, based on literature review and experiences of clinical practice, address the anatomical variation features of the RLN and the indications and surgical techniques for five different exposure methods of the RLN.