Abstract The presence of palpable cervical lymphadenopathy in patients with carcinoma of the thyroid nearly always indicates the presence of metastases to the nodes. A radical neck dissection is indicated in the surgical treatment of most of these patients who are otherwise operable (primary lesion can be removed). In our experience at least one-third of patients with carcinoma of the thyroid but without palpable cervical lymphadenopathy do have metastases to the cervical nodes. Whether or not cervical node dissections should be used for these patients is, therefore, not decisively established. However, a modified neck dissection is considered justified in the surgical treatment of many of this group of patients and better results are suggested if it is done. A modified neck dissection has been defined as a dissection which is identical to the classical radical neck dissection except for the preservation of the sternocleidomastoid muscle and the submaxillary gland area. This includes removal of the nodes adjacent to the thyroid and presupposes complete removal of the primary lesion.