Abstract: Objective To explore reasonable surgery in the treatment of thyroid diseases. Methods A retrospective analysis was performed on data of 129 patients with thyroid tumors underwent surgery, and the patients were divided into group A(thyroidectomy, n=58), group B(unilateral total thyroidectomy, n=40)and group C(bilateral subtotal thyroidectomy, n=31). The surgery conditions(operative time, intraoperative blood loss, drainage volume at 24 h after surgery, hospital stay)and parathyroid function before and after surgery ［blood calcium(Ca²⁺), parathyroid hormone(iPTH)］ were compared among the three groups, and the incision pain degrees were evaluated at different time points after surgery. The incidence rate of surgical complications and the recurrence rate during 1-year follow-up were compared. Results There were significant differences among the three groups in the operative time, intraoperative blood loss, drainage volume at 24 h after surgery and postoperative hospital stay(P<0.05), with the highest in group C and lowest in group A. The levels of iPTH and Ca²⁺ after surgery were decreased in the three groups(P<0.05), and the indexes in groups B and C were lower than those in group A, and the group C was lower than the group B(P<0.05). The Visual Analogue Scale(VAS)scores at different time points after surgery in the three groups showed that it was the lowest in the group A and the highest in group C(P<0.05). There were significant differences in the incidence rates of hypocalcemia, thyroid dysfunction and total incidence rate of complications among the three groups(P<0.05), and the incidence rates from low to high were as follows: group A, group B, and group C(P<0.05). The recurrence rate of group A was higher than that of group B and group C, but there was no statistically significant difference among - the three groups(P>0.05). Conclusion Among the three surgical procedures, thyroidectomy has the lowest trauma, lower pain level, quicker postoperative recovery, smaller impacts on parathyroid function, less complications but higher postoperative recurrence rate. Unilateral total thyroidectomy has better resection effects, relatively less incidence of complications, and lower risk of recurrence.