Objective: To investigate the clinical efficacy of using “the most inferior approach” in identification of the recurrent laryngeal nerves (RLNs) during thyroid surgery. Methods: The clinical data of 22 patients undergoing thyroidectomy in Huainan No.1 People’s Hospital from December 2017 to April 2018 were retrospectively analyzed. All patients underwent identification and dissection of the RLNs through “the most inferior approach” to protect and avoid injury of the RLNs during surgical procedure. Results: Thyroid lobectomy was the main surgical procedure for the 22 patients, including unilateral or bilateral thyroid lobectomy in 17 cases for benign thyroid diseases, and radical resection in 7 cases for malignant tumor of the thyroid. All the RLNs of the operative sides (26 RLNs) were found during surgery, and no damage of the RLNs occurred in any of the patients. Thyroid surgery was safely performed in all patients. Conclusion: “The most inferior approach” is the concept of a way and method for exposure of the RLNs besides the conventional “superior, middle and inferior approaches”, and is also standardized and easily reproducible. This method is recommended to be used for its safety, simpleness and high accuracy, especially in patients with anatomical abnormalities caused by thyroid enlargement or severe adhesions, as well as in those with history of thyroid surgery requiring a repeat thyroidectomy.