Abstract: Objective To compare the short-term effect and safety of bilateral areolar approach endoscopic thyroidectomy versus traditional open surgery in the treatment of papillary thyroid carcinoma,and explore the application prospect of bilateral areolar approach endoscopic thyroidectomy for thyroid papillary carcinoma. Methods A retrospective cohort study was performed.According to the inclusion and exclusion criteria,clinical data about patients undergoing radical resection of thyroid papillary carcinoma in the first medical center of Chinese PLA General Hospital from March 2016 to March 2018 were continuously collected.A one to one propensity score matching （PSM） method was performed for establishing the open group and endoscopy group.Main observational indexes including time for preparing surgery,operating time,blood loss,number of lymph nodes dissected,complications,length of hospital stay,hospitalization cost,local recurrence at 1 year,satisfaction with incision appearance,were compared between the two groups. Results After PSM matching,44 cases were in the open group and 44 cases were in the endoscopy group.There was no significant difference in preoperative general data between the two groups （P>0.05）.For intraoperative data,no significant difference was detected in operating time,blood loss,the exposure of recurrent laryngeal nerve,the number of dissected lymph nodes and the number of positive lymph nodes （all P>0.05）.The time for preparing surgery in the endoscopy group was significantly longer than that of the open group （24.93±4.91） min vs （22.70±4.67） min,P=0.032.There was no statistically significant difference in blood calcium,blood PTH,complications,time to remove drainage,length of hospital stay,radioactive Iodine (I¹³¹) therapy,and local recurrence in 1 year between the two groups （P>0.05）,but the hospitalization cost in the endoscopy group was higher than that in the open group （21 889.51±1 895.25 yuan） vs （20 659.51±1 789.58 yuan）,P=0.002.The endoscopy group was superior to the open group in satisfaction with incision appearance （90.9% vs 50.1%,P<0.001）. Conclusion Bilateral areolar approach endoscopic thyroidectomy is not inferior to traditional open surgery in safety and short-term effect in the treatment of thyroid papillary carcinoma,but could be an option for patients pursuing good cosmetic effect.