Abstract: Objective To explore the safety, effectiveness and feasibility of endoscopic surgery for thyroid cancer via chest and mammary areola approach．Methods We retrospectively analyzed 46 patients with thyroid cancer who underwent endoscopic surgery via chest and mammary areola approach, and summarized and discussed the information about general status, surgical procedures and techniques, operation time, operative blood loss, duration and volume of postoperative drainage, complications, etc. Results All cases were successfully executed through endoscopy; nine cases received lobectomy plus isthmectomy, 28 cases received lateral lobectomy plus isthmectomy and contralateral partial or subtotal thyroidectomy, nine cases received total thyroidectomy, and 21 cases underwent central neck dissection. The maximum diameter of nodes was (1.63±0.75)cm, operation time was (108.15±32.60)min, the operative blood loss was (34.46±18.42)ml, duration of postoperative drainage was (3.52±0.94)d and overall drainage volume was (157.41±103.45)ml. Parathyroid glands were identified in nine specimens while no case of permanent postoperative hypocalcaemia; three cases experienced temporary hoarseness, one case experienced intraoperative skin scalding, and one case experienced postoperative infection; eight cases were pathologically confirmed as central lymph node metastasis; four cases failed to intraoperative definite pathological diagnosis and one of them experienced secondary open surgery. All cases were followed up for 0-48 months without relapse or metastasis. Conclusion Endoscopic surgery via chest and breast areola approach is a selectable procedure for thyroid cancer which could acquire satisfactory cosmetic results and short-term effects, but appropriate candidates and concrete operative modes should be carefully selected.