<p>Surgical resection remains the mainstay of curative intent therapy for patients with differentiated thyroid cancer, with radioactive iodine ablation and/or TSH suppression commonly employed in the adjuvant setting. Alternative strategies such as active surveillance and ablation are potentially available for patients with very low risk disease, although data regarding long term oncologic outcomes are limited. While only a small subset of patients with DTC will require systemic therapy, an increased understanding of tumor mutation profiles and available targeted therapies may facilitate multidisciplinary treatment of patients with locally advanced and/or unresectable DTC. This landmark series will summarize key studies that shape current guidelines in the surgical management of DTC and its adjuncts, with particular attention to current controversies and novel therapeutics that impact surgical management.</p>