：Objective To explore thesafety of total thyroidectomy surgery on patients with thyroid carcinoma. Methods From Jan1986 to Dee 2006, clinical data of patients who underwent total thyroidectomy (totalthyroidectomy group) and sub-total or near-total thyroidectomy surgery (control group) forthyroid carcinoma were retrospectively analyzed to identify the incidences ofcomplications, recurrent laryngeal nerve paralysis (RNLP) and secondary hypoparathyroidismin the two groups. Results In the control group there were 433 thyroid carcinoma patientswho underwent sub-total or near-total thyroidectomy. Transient unilateral RLNP(13 eases),permanent unilateral RLNP(5 eases), transient hypoparathyroidism (11 cases) was diagnosed.There was no permanent hypoparathyroidism in this group. In the 70 cases of thyroidcarcinoma patients receiving total thyroidectomy, there were 4 eases suffering fromtransient unilateral RLNP, one case from permanent unilateral RLNP (P > 0.05), andthere were 7 eases from transient hopyparathyroidim (P < 0.01), 2 eases from permanenthypoparathyroidism (P < 0.05). Conclusion The incidence of RLNP after totalthyroidectomy was not higher than that after subtotal or near-total thyroideetomy.Postoperative hypocalcaemia was the most common postoperative complication of totalthyroidectomy. It is our belief that total thyroidectomy should be performed in selectedpatients.