Objective: The aim of the study was to investigate the value of minimally invasive video-assisted thyroidectomy for thyroid benign adenoma. Methods: From June 2003 to June 2007, 128 cases of thyroid tumors, including 123 cases of adenoma and 5 cases of carcinoma, were performed by Miccoli’s endoscopic thyroidectomy. The surgical techniques and the clinical outcomes with respect to pathologic results, duration of operation, postoperative drainage, pain, cosmetic results and complications of endoscopic thyroid surgery via the neck approach were retrospectively summarized. Results: All the patients underwent minimally invasive endoscope-assisted thyroidectomy successfully. Five cases of carcinoma revealed by frozen section. In which, 3 papillary carcinoma cases underwent subtotal thyroidectomy of disease-side in video-assisting, whereas the other 2 cases with follicular and medullary carcinoma underwent conventional total thyroidectomy of disease-side combined with subtotal thyroidectomy of the opposite-side. The transient hoarseness occurred in one patient and recovered well one week later, and the other patients recovered successfully without any complications. Conclusion: Minimally invasive video-assisted thyroidectomy for thyroid adenoma is safe and reliable. This procedure offers a shorter incision, less invasion and better cosmetic results as compared with conventional thyroidectomy.