Objective To analyze the application effect of modified V-shaped supine position in total areolar approach endoscopic thyroid surgery.Methods 150 patients who underwent total areolar approach endoscopic thyroid surgery in the Second Hospital of Sanming City from January 2021 to December 2022 were selected and divided into two groups by random drawing,with 75 cases in each group.The control group was placed in the tra-ditional V-shaped supine position,and the observation group was placed in the modified V-shaped supine position.The effects and satisfaction of the surgical position applied in the two groups were compared.Results In the observation group,82.67%experienced mild discomfort,14.67%experienced moderate discomfort,and 2.67%experienced severe discomfort.There was a statistically significant difference in postoperative comfort between the observation group and the control group(all,P<0.001);the observation group had shorter postoperative bed rest time and hospital stay than those of the control group(all,P<0.05);the incidence of complications in the observa-tion group and the control group were 16.00%and 34.67%respectively,with a statistically significant difference(P<0.05);the overall satisfaction rates in the observation group and the control group were 97.33%and 77.33%respectively,with a statistically significant difference(P<0.05);the subjective fatigue scores of doctors in the obser-vation group were significantly lower than those in the control group(P<0.05).Conclusion The use of modified V-shaped supine position in total areolar approach endoscopic thyroid surgery can improve patient comfort,reduce the incidence of complications,shorten patient recovery time,and alleviate doctor fatigue,providing more reference for adjusting the surgical position in total areolar approach endoscopic thyroid surgery.