Non-recurrent laryngeal nerve (NRN) is an anatomical abnormality that, although rare (0.03-1% on the right,only 4 cases on the left), represents a serious threat of nerve lesion during thyroidectomy. Its existence is highlighted in the peroperative phase and it is also accompanied by other anatomical abnormalities, such as the presence of the Lusor artery.Recently intra operative neuro-monitoring (IONM) of recurrent nerves has been introduced during thyroidectomy in order to reduce the incidence of nerve injuries.During setting phase of IONM, the lack of cervical vagus nerve signal (VN1) indicates the presence of NRN. In this case the emergence of NRN occurs at the high cervical level before entering the larynx directly without reaching the mediastinum. This video shows a case of NRN during the setting up of IONM. The lack of signal means the presence of non-recurrent laryngeal nerve. We continued the dissection until the emergence of the inferior laryngeal nerve was highlighted, whose nature was confirmed by the registration of potential with the correct graphic configurations. The procedure, performed with MIVAT technique, continued with the positioning of a vagal electrode for continuous stimulation above the nerve emergency up to the crico-pharyngeal muscle. The video demonstrates the usefulness of the neuromonitoring system in preventing injuries in case of NRN and the possibility to perform a continuous IONM during of MIVAT.