The current study compared results between endoscopic thyroidectomy and conventional surgery in a prospective study. Twenty-two patients eligible for endoscopic thyroidectomy were evaluated. Patients were divided into group A, for conventional open thyroidectomy (n = 12), and group B, for endoscopic thyroidectomy (n = 10). Operative time, blood loss, postoperative complications and analgesic requirements, and time taken to return to normal activity were compared. Groups A and B were statistically balanced. Blood loss was significantly less in group B than in group A (11 versus 32 mL; P = 0.004), but no significant differences were observed in any of the other parameters. No postoperative complications (hemorrhage or recurrent laryngeal nerve paralysis) were present in either group. Compared with conventional surgery, endoscopic thyroidectomy for benign thyroid nodules was associated with less blood loss, although blood loss was minimal for both procedures. There were no practical differences in technical ability to perform.