Purpose. The authors describe a technique of minimally invasive video-assisted thyroidectomy (MIVAT) they recently developed, analyzing the preliminary results obtained. Methods. Fifty patients were included in the study, 42 of whom underwent lobectomy and 8 total thyroidectomy. The procedure begins with a 15-mm incision above the sternal notch. After opening the cervical linea alba, dissection of the gland is carried out under endoscopy, using both conventional and endoscopic instruments. Gas insufflation is not necessary. The magnification offered by the endoscope allos for easy identification and preservation of the recurrent nerve and parathyroid glands. Results. Mean operating time was 82 minutes for lobectomy and 120 minutes for total thyroidectomy. In 2 cases (4%), conversion to traditional cervicotomy was required. Posteoperative complications were limited to one case of hypocalcemia. Conclusions. MIVAT can be considered a safe and feasible procedure. Although the indications are stilllimited, the results of the study are encouraging and the Authors are optimistic about the future of video-assisted surgery.