INTRODUCTION: Patients with thyroid nodules account for up to 3-8% of the population. Aspiration cytology enables early diagnosis of suspicious nodules of increasingly smaller sizes, which has increased the number of surgeries performed. Minimally invasive video-assisted thyroidectomy (MIVAT) represents a potentially less aggressive option. OBJECTIVE: To evaluate the use of MIVAT in the treatment of thyroid nodules, and to compare this with conventional thyroidectomy (CT). CASUISTRY AND METHODS: The study included patients who underwent a thyroidectomy between September 2011 and February 2013 for the treatment of thyroid nodules with a surgical indication. The patients were divided into 2 groups: those who underwent CT (n = 30) and those who were assessed with MIVAT (n = 18). Patients eligible for MIVAT were those with masses up to 3 cm in size, a thyroid lobe volume to be removed of up to 20 cm³, and that without any suspected adenopathy. RESULTS: The histopathological CT and MIVAT outcomes were, respectively, as follows: cancer, 33.33% and 33.33%; colloid/adenomatous goiter, 56.67% and 33.33%; Hashimoto's thyroiditis, 10.00% and 11.11%; and adenoma, 0.00% and 22.22%. The mean duration of surgery and hospital stay was 130.0 minutes and 5.8 days for CT, and 119.5 min and 3.1 days for MIVAT. Drain placement was necessary in 79.31% of CT patients, but was not necessary for any MIVAT patient. The surgical scar measured 3 cm for MIVAT, but 7-10 cm for CT. CONCLUSION: MIVAT is superior to CT because it the duration of surgery is reduced, as are the length of hospital stay and the size of the surgical scar.