Objective:To explore to simply the method of endoscopic thyroid surgery and to promote the application of endoscopic thyroid surgery in clinic. Methods:Fiftyfive patients underwent endoscopic thyroidectomy via the anterior chest wall approach between June 2004 and May 2007 in the Southwest Hospital of the Third Miliary Medical University.Of 55 patients, 40 cases suffered with thyroid adenoma including 15 in bilateral side,25 in half side and 1 in isthmic portion,and 15 cases suffered with nodular goiter.The size of mass was 05～60cm.Cervial plexum and local infiltration anaesthesia were performed in all patients. Trocars were inserted at 12cm below fossa suprasternalis.Skin flap was liberated between latissimus colli and anterior jugular muscles with electric knife. Linea alba cervicalis was opened by electric knife,anterior jungular muscles were liberated and drawn upward.The masses of thyroid were caught with no damage clamp and removed completely with ultrasound knife. Results:The effect of Cervial plexum and local infiltration anaesthesia were satisfying in 53 cases.Of 55 patients,25 patients undewent bilateral partial thyroidectomy,29 partial hemithyroidectomy,and 1 isthmic portion resection.The mean operation time was 95 (45～150) min.The complications occurred in 3 patients,including transient hoarseness in 1 patient on the second day after the operation and recovered well 1 month later. Conclusion:The endoscopic thyroid surgery could be completed with cervial plexum and local infiltration anaesthesia. The endoscopic manipulation could be simplified via anteria chest wall approach and with the suitable length of subcutaneous path (about 12cm ).The operation time could be shortened by using both electric knife and ultrasound knife.