Background and Aims After clinical exploration, our team has introduced improvements and innovations to the traditional trans-subclavian approach endoscopic thyroidectomy, focusing on surgical incision localization, surgical pathway, and surgical instruments. This article was written to serve as a reference for colleagues.Methods Utilizing surgical video footage, data of one case of gasless endoscopic right thyroid lobectomy with right central lymph node dissection by trans-subclavian approach performed by our team was presented, along with review of relevant literature and discussion.Results The operation was successfully completed under endoscopy, with a total operative time of 65 min and an estimated blood loss of about 5 mL. Postoperative recovery was satisfactory, and the patient was discharged with tube removal on the 2nd postoperative day. The total drainage volume was 100 mL, and the postoperative hospital stay was 2 d.Conclusion The modified gasless trans-subclavian approach endoscopic thyroidectomy for treating papillary thyroid carcinoma is safe and feasible, with thorough central neck dissection, excellent incision concealment, and low operative difficulty. So, it has clinical application value.