Abstract: Objective : To compare the clinical effects of endoscopic thyroidectomy using an approach through thebreast and conventional open thyroidectomy for benign thyroid diseases. Methods : A total of 207 cases of be-nign thyroid diseases were surgically treated from August 2002 to May 2008, including 102 cases that under-went endoscopic thyroidectomy (endoscopic group) and 105 cases that underwent traditional thyroidectomy(traditional group). The surgery duration, hospitalization cost, blood loss, Visual Analogue Scale (VAS) scoresfor pain severity, hospital stay, postoperative requirements for analgesics, volume of drainage, and postopera-tive complications were compared between the two groups. Results : No significant difference was found in in-traoperative blood loss between the two groups. Compared with the traditional group, the endoscopic grouphad longer surgery duration (P=0.001), longer hospital stay (P=0.170), higher hospitalization cost (P=0.000)and larger volume of drainage (P=0.000). There were fewer cases who needed analgesics after surgery in theendoscopic group than in the traditional group (16 cases vs. 52 cases, P=0.000). No significant differencewas found in the incidence of recurrent laryngeal nerve paralysis between the two groups. Conclusion : Com-pared with conventional surgery, endoscopic thyroidectomy is a feasible, practical and safe procedure for be-nign thyroid diseases, with excellent cosmetic benefits and less pain. Further studies are warranted to over-come the shortcomings of endoscopic thyroidectomy including higher hospitalization cost, longer hospitalstay, and larger volume of drainage after surgery.