Objective：To analyze the complications，recurrence and vicarious therapeutic dosage of total thyroidectomy（TT） and sub-total thyroidectomy（STT），and to explore the clinical value of total thyroidectomy in the treatment for patients with benign thyroid diseases. Methods：Totally 86 patients with bilateral multiple nodular goiter in our department from May 2009 to May 2010 were ana－lyzed retrospectively. Patients were divided into 2 groups： group A（48 patients underwent bilateral STT） and group B（38 patients underwent bilateral TT）. Results：All 86 patients were diagnosed as benign thyroid diseases by pathologic examination. Three patients in group A and 2 in group B experienced temporary postoperative laryngeal nerve injury（P >0.05）. Two patients in group A and 2 patients in group B had temporary postoperative hypoparathyreosis（P >0.05）. The operation time was （96.85±22.93） min in group A and （79.05±19.34） min in group B（P<0.05）. The intraoperative blood loss was （110.33±29.98） ml in group A and （58.03±20.09） ml in group B（P<0.05）. The vicarious therapeutic dosage was （131.77±39.19） μg/d in group A and （300.66±48.45） μg/d in group B（P<0.05）. Eight patients in group A and no patient in group B suffered recurrence. No patient had permanent laryngeal nerve injury and hypoparathyreosis. Conclusion：With the advantages of less intraoperative blood loss，shorter operation time，lower postoperative recurrence rate and complication rate，TT is superior to STT in the treatment of thyroid multi-nodular diseases，although higher vicarious therapeutic dosage is required for STT after the surgery.