In endoscopic thyroid surgery, the visualization of the external branch of the superior laryngeal nerve (EBSLN) is insufficient and the time to exposure of the EBSLN is variable, due to the space constraints, application of energy-based devices, interference between the working arms and different perspectives resulted from different approaches. So, the protection of the EBSLN is more difficult than that in open surgery, and furthermore, the conventional methods have several limitations for its protection. The application of intraoperative neuromonitoring technique with standardized process can not only allow precise positioning but also provide quantitative indicators to improve the surgical safety. Here, the authors address the application progress of intraoperative neuromonitoring of the EBSLN during endoscopic thyroid surgery based on a review of literature in China and abroad.