Objective To summary the change of surgical approaches, indications, contraindications, and complications of endoscopic thyroidectomy. Methods Endoscopic thyroidectomy related literatures at home and abroad were collected to summary the change of surgical approaches, indications, contraindications, and complications of it. Results The approaches of endoscopic thyroidectomy had their own advantages, wherein breast and complete areola approaches were mainstream surgical procedures; the indications were closely correlated with surgeons and devices, and there were no uniform indications yet. With the advance in endoscopic techniques, the contraindications would be gradually resolved, and the assistance of new devices and the accumulation of experience reduced the incidence of surgical complications, but there were still probability of occurrence of such complications. Conclusion Endoscopic thyroidectomy is the main means of treating thyroid nodules, which will be more widely used with the advance in techniques, the innovation of devices, the expansion of indications as well as the overcoming of contraindications.