BACKGROUND: During the last decade the surgical technique of minimally invasive video-assisted thyroidectomy [MIVAT) has evolved worldwide. This approach provides Less morbidity and better cosmetic results with the same clinical outcome. PURPOSE: The aim of this study was to assess the feasibility and efficacy of MIVAT, a new minimally invasive technique for thyroid surgery. METHODS: A retrospective analysis of patients who underwent MIVAT between 2007 and 2009 was conducted. For control, we used a demographically and clinically similar group of patients who underwent conventional open thyroidectomy. RESULTS: During the study period 18 patients with a solitary thyroid nodule underwent MIVAT. Indication for surgery was a hyperplastic nodule in all cases. The mean nodule diameter was 1.8 cm in the final pathological examination. Mean operating time was 80.3 minutes compared to 50.27 minutes in the open approach group (p < 0.001). Hospitalization time was significantly shorter in the MIVAT group compared to the open thyroidectomy group, 3.2 versus 4.5 days (p < 0.001). There were no major complications, but 4 patients developed transient vocal cord paralysis and two had wound infection in the MIVAT group, compared to none and one respectively in the control group. CONCLUSIONS: MIVAT is a technically feasible and safe procedure that leads to an improved cosmetic result and a quicker recovery. The prolonged operation time and minor complications warrant further experience in our institution.