Differentiated thyroid cancer (DTC) is the most common type of thyroid cancer, accounting for over 94% of cases. Currently, the main treatments include radical surgical resection, selective radioiodine (¹³¹I) therapy, and thyroid-stimulating hormone (TSH) suppression therapy, with generally good overall prognosis. TSH can bind to TSH receptors expressed by DTC cells, stimulating their growth. Therefore, TSH suppression therapy is a crucial step in reducing the risk of tumor recurrence in DTC patients after surgery, and it has been clearly recommended by multiple guidelines both at home and abroad. However, in clinical practice, some patients still find it difficult to achieve the TSH suppression therapy goals, requiring repeated adjustments of the treatment dose to reach the desired targets. During the treatment process, patients may experience discomfort such as fatigue, drowsiness, or palpitations. This article mainly summarizes the factors influencing the efficacy of TSH suppression therapy after DTC surgery, aiming to help clinicians provide better postoperative TSH suppression treatment and follow-up management for DTC patients, thereby improving their quality of life, extending long-term survival, and reducing postoperative recurrence rates of DTC.