The skin incision, correct plane of elevation of flaps, and reflection of pretracheal (sternohyoid and sternothyroid) musculature are demonstrated. This video depicts the correct method of mobilization of the sternocleidomastoid muscles and the thyroid gland, along with maintenance of a clean hemostatic field. Close-up magnified views of both recurrent laryngeal nerves and inferior thyroid arteries are provided. Some of the parathyroid glands and a method of preservation of their blood supply are portrayed. Identification and ligation of the superior thyroid artery and control of the small distal aborizations of the inferior thyroid artery are displayed.