Endoscopic thyroidectomy via axillo - bilateral - breast - approach with harmonic scalpel is both safe and cosmetic. Objectives: Describe the technique and evaluate efficacy of this procedure. Materials and Methods: Descriptive study, all patients have the goiter treated by endosopic thyroidectomy via axillo - bilateral - breast - approach with harmonic scalpel from 6 / 2008 to 6/2009 in Binh Dan hospital. Results: 40 cases (8 males - 32 females) of endoscopic thyroidectomy axillo - bilateral - breast - approach with harmonic scalpel were done with a 3 month follow-up.