To evaluate the role of Intraoperative neuromonitoring (IONM) in visual and functional identification of external branch of superior laryngeal nerve (EBSLN) during thyroidectomy operation, 2. To identify the anatomical variations of EBSLN according to Cernea classification. This is a prospective observational study done on 30 patients who underwent thyroidectomy operation at the Department of Otorhinolaryngology in a tertiary medical institute. EBSLN was visually located and identified which was then confirmed by IONM. Identified nerves were classified according to Cernea classification. Results: Out of 34 EBSLNs, a total of 30 (88.2%) nerves were identified. Visual identification was successful in 19 (55.9%) nerves and 28 (82.4%) EBSLNs were functionally confirmed by IONM. Additionally, 11 (32.4%) branches were identified only by IONM which was statistically significant (