Background: Same-day thyroidectomy has not gained widespread acceptance owing to concerns of life-threatening complications. The aim of this study is to describe a single institution same-day thyroidectomy results. Methods: We included patients who underwent thyroid surgery between 2005 and 2011 by a single surgeon. The outcomes of patients who underwent inpatient (IP) and same-day thyroidectomy were compared. Routine postoperative parathyroid hormone testing for same-day thyroidectomy commenced in 2010, and results were also compared after that date. Results: Thyroid surgery was performed in 608 patients; 298 (49%) were performed as same-day thyroidectomy. Patients undergoing same-day thyroid lobectomy had similar, low documented complication rate as IP lobectomy. Patients with same-day total thyroidectomy (SDTT) had similar rates of documented transient hypocalcemia and neck hematoma compared with IPs. After 2010, all patients without restrictive underlying comorbidities were scheduled for same-day thyroidectomy unless otherwise specifically requested by the patient. Only 4 (3%) patients scheduled for SDTT were converted to IPs, all without neck complications. Conclusion: Same-day thyroidectomy is safe and can be routinely performed by experienced surgeons who have low complication rates and a patient support system. © 2012 Mosby, Inc. All rights reserved.