Objective To compare the efficacy of non-inflatable transvestibular approach and non-inflatable transaxillary approach in endoscopic treatment of thyroid cancer.Methods The clinical data of 95 patients with unilat-eral thyroid cancer admitted to West Branch of the First Affiliated Hospital of University of Science and Technology of China from January 2019 to June 2023 were retrospectively analyzed.Among them,45 patients were selected from those who underwent simultaneous transaxillary endoscopic surgery,and the other 50 patients were randomly selected from those who underwent simultaneous transvestibular endoscopic surgery.The perioperative data and postoperative follow-up results of the two surgical methods were compared.Results There were no significant difference in operation time,intr-aoperative blood loss,hospital stay,3-day drainage volume,postoperative complications and aesthetic satisfaction between the two groups(P>0.05).The number of lymph nodes in the transvestibular group was higher than that in the axillary group(P<0.05).Conclusions Endoscopic thyroid surgery through oral vestibular approach can achieve scar-free body surface with obvious advantage in the dissection of central lymph nodes over the transaxillary approach.