In recent years,the incidence of thyroid diseases has been soaring year by year,and the trend of youthfulness is significant.Surgery is an effective method to treat thyroid diseases.Traditional open surgery has obvious neck scars,which seriously affects patients'beauty and quality of life.With the development of endoscopic technology and the increase of cosmetic needs of patients,endoscopic thyroid surgery has developed rapidly,and various approaches and methods have been derived.Each approach has its advantages,disadvantages and indications.The evolution,advantages,disadvantages and development trend of various mainstream approaches in endoscopic thyroid surgery are reviewed.