In thyroid surgery, the effective protection of the parathyroid glands can have a significant impact on the prognosis of patients. Currently, intraoperative protection of the parathyroid glands is mostly based on visual identification. Surgeons decide whether to perform autotransplantation based on the observed morphology and blood supply of the parathyroid glands during surgery. However, the close resemblance of the parathyroid glands to surrounding fat and lymphatic tissues in morphology and color significantly affects the efficacy of visual identification. Therefore, there is an urgent need for a method to assist surgeons in rapidly and effectively identifying the parathyroid glands during thyroid surgery. In recent years, the application of fluorescence imaging technology in thyroid surgery has become a research hotspot. This technology is used to visualize the parathyroid glands and their blood supply during surgery, providing a new method for intraoperative protection of the parathyroid glands. Fluorescence imaging technology can be divided into near-infrared autofluorescence imaging (NIRAF) and exogenous fluorescence. The principles, equipment used, and real-time imaging effects vary between different fluorescence imaging methods. At present, NIRAF is mostly used for intraoperative identification of parathyroid glands, improving the surgeon's identification rate. However, its imaging effectiveness is influenced by various factors such as the patient's blood calcium concentration, the location of the parathyroid glands, and the surrounding tissue conditions. Exogenous fluorescence imaging relies on the application of fluorescence imaging agents, including indocyanine green (ICG), low-dose methylene blue (MB), and 5-aminolevulinic acid (5-ALA). The most widely used fluorescence imaging agent is ICG, which, when specifically bound to blood lipoproteins, can be visualized under near-infrared light, aiding the surgeon in identifying the parathyroid glands and assessing the surrounding blood supply. In recent years, ICG has gradually been applied in endoscopic and da Vinci robotic surgeries as more thyroid procedures are performed. However, this method has limitations as it may result in false-positive and false-negative results in identifying the parathyroid glands, and the surgeon's judgment of the blood supply around the parathyroid glands can be influenced by subjective factors. Other exogenous fluorescence imaging methods, such as the use of low-dose MB and 5-ALA, can also perform fluorescence imaging of the parathyroid glands. Still, there are reports of adverse reactions, limiting their widespread clinical application. As the research on fluorescence imaging for parathyroid protection is still in its early stages both domestically and internationally, there is ongoing debate about the clinical application methods and effectiveness of different technologies. Based on current literature from both domestic and international sources, the authors summarize relevant reports on fluorescence imaging technology and parathyroid protection.