With the development of endoscopic techniques and perfection of surgical skills in thyroid surgery, endoscopic approaches have been increasingly used in thyroid surgery. However, the indications and appropriate selection of the endoscopic procedures for endoscopic thyroid surgery are still controversial in practical application. There is no doubt that endoscopic techniques offer benefits for the thyroid patients, but the strict adherence to indications, standardized treatment strategies, strong surgical skills and individualized treatment to a specific patient are still of great importance.