Abstract: Abstract Objective：To summarize the protection method of parathyroid glands in total thyroidectomy. Methods：Clinical data of 42 patients who were treated by total thyroidectomy in our hospital from 2009.10 to 2014.6 were retrospectively analyzed. The level of serum PTH and blood calcium before and after surgery were compared. Result：19 cases (45.2%)had decreased PTH and 9 cases (21.4%)had complicated symptomatic hypocalcemia, and the level of serum PTH and blood calcium return to normal at 30 days after surgery. Perpetual hypoparathyroidism was not found. Compared with before treatment, the level of serum PTH was significantly decreased(P<0.05), while there was no difference at 30 days after surgery(P>0.05). There was no difference on the level of blood calcium compared with that before surgery expect that at 1st and 3rd day after surgery. Conclusions: To strengthen the identify of parathyroid anatomical location and protection of blood supply in total thyroidectomy, which can effectively reduce postoperative parathyroid damage, avoid severe complications.