Thyroid cancer is the most common malignant tumor in the endocrine system, with a steadily increasing prevalence worldwide. Total thyroidectomy is currently a commonly used treatment for this disease. The parathyroid glands, located on the posterior mid and lower regions of the bilateral thyroid lobes (or embedded within them), are crucial for maintaining calcium and phosphorus homeostasis in the human body. Reduced function of these glands can lead to symptoms such as decreased blood calcium concentration, muscle spasms, and, in severe cases, death. Due to the small size and variable distribution of the parathyroid glands, locating and preserving them during thyroid surgery is challenging. Damage to the parathyroid glands during surgery can result in reduced function and postoperative complications, such as decreased blood calcium concentration. To reduce the risk of parathyroid damage during total thyroidectomy and prevent postoperative complications, the authors provide a comprehensive analysis of several mainstream methods for parathyroid localization and identification during thyroid surgery, which mainly include techniques based on staining methodology, optical approaches, and parathyroid hormone monitoring. The technical features and advantages of each method, providing a detailed overview of their application scenarios and technical limitations are analyzed and compared. The aim is to advance the development of parathyroid identification technology in thyroid surgery, laying a technical foundation for the rapid and accurate identification and preservation of parathyroid glands during surgery.