Abstract: Surgery is the major treatment option for malignant tumors and some benign neoplasms of the thyroid, most of which are differentiated thyroid carcinoma. Despite the progresses that have been made in surgical techniques, iatrogenic injuries of the parathyroid and laryngeal nerves, including superior and recurrent laryngeal nerves, could not be completely avoided in the surgical management of thyroid tumors. In this review, the causes of intraoperative injuries of parathyroid and laryngeal nerves are systematically analyzed with respect to types and extents of surgical operations, changes in topical anatomy, and secondary thyroid surgeries. The principles and strategies for protecting and restoring injuries of the parathyroid and laryngeal nerves are also elucidated for the effective prevention and adequate treatment of these major complications in the thyroid surgery.