With the rapid rise in the incidence of thyroid cancer, the number of thyroidectomies has increased remarkably in the last 10 years. Thyroidectomy accounts for approximately 40% of the workload in head and neck fellowship. The decision making in thyroid surgery is quite complex, especially when patients present with recurrent or advanced thyroid cancer. The complications of thyroid surgery can be very serious in relation to quality of life. Some of these complications can be avoided with meticulous surgical technique. Thyroid surgery continues to span various specialties, and surgical volume continues to be an important parameter in outcomes. Technological advances have made a significant impact in thyroid surgery; however, these need to be carefully evaluated before their routine implementation and for extracervical approaches to thyroidectomy. The use of external radiation therapy and targeted therapies has expanded in recent years for patients with recurrent thyroid cancer. In a specialized and tertiary care center, the thyroid expert should be well-trained to make appropriate complex decisions. Thyroid experts should be part of the multidisciplinary team managing thyroid cancer from A to Z.