The case described in this video deals with a 54-year-old female patient with a huge multinodular goiter. The patient underwent a total thyroidectomy performed using Continuous Nerve-Monitoring. Preventing recurrent laryngeal nerve (RLN) injury during thyroid surgery requires good visualization and exposure of the RLN, adequate knowledge of RLN anatomy, adequate surgical experience and training.The continuous intra-operative nerve monitoring (C-IONM) technique during thyroid surgery is acknowledged as a useful tool to prevent impending recurrent laryngeal nerve injury. Indeed, it constantly provides valuable real-time information about the integrity of the nerve.The prevalence of IONM in thyroid surgery has increased significantly over the past decade, with 83% of surgeons using IONM in some or all cases. Although IONM use may be more widespread in North America, attitudes toward its implementation are fairly uniform. IONM use is more prevalent among younger surgeons, whereas its use has no correlation with thyroid surgery volume or type of practice.This video shows a case of total thyroidectomy performed using C-IONM. The procedure is presented step by step with a detailed display of the neck structures. Concurrent EMG reports showed the integrity of the nerve.The procedure has no complications. The post-operative course was uneventful and the patient was discharge in I post-operative day. After a 30-day follow-up, the patient is in excellent clinical condition without any voice alteration.