Both sides of axillary approach is pure endoscopic thyroidectomy with carbon dioxide insufflation on 24 patients from July 2007 to June 2010. There were 18 patients of thyroid carcinoma and 6 others of nodular goiter diagnosed preoperatively. All of them are female(100 percent) with tumor size from 1-4cm in 21 (87.5 percent) cases and 4cm in 3 (12.5 percent) patients, central lymph node dissection and modiffied lateral lymph node dissection, follow-up by TG level. Total thyroidectomy, total thyroidectomy with central lymph node dissection and modiffied lateral lymph node dissection were in 17 (70.8 percent) and in 7 cases (29.2 percent) respectively. The mean operative time was 108 minutes (80-180). Histopathology data: the papillary carcinoma was in 23 cases (95.8 percent), follicular carcinoma was in 1 case and lymph node metastasis was in 2 patients. There were no case of permanent hypoparathyroidism and horseness. 1 patient has posterior cordectomy becaused 01 permanent respiration failure. Total thyroidectomy with or without lymph node dissection is safely and effectively for thyroid carcinoma treatment.