Thyroid radiofrequency ablation (RFA) is an effective, well-tolerated, and safe therapeutic strategy for treating thyroid nodules with a low complication rate when performed by skilled operators. According to the Society of Interventional Radiology, major complications are those that, if left untreated, could endanger the patient’s life, leading to significant morbidity or disability or resulting in an extended hospital stay. All other complications are considered minor. Side effects that may occur during the procedure include intense pain, intranodular or pericapsular bleeding, vasovagal reaction, and intense cough. Immediate post-operative side effects occurring 24–48 h after the procedure may include swelling, cutaneous burn, transient laryngeal dysfunction, permanent laryngeal dysfunction, brachial plexus injury, and Horner’s syndrome. Periprocedural side effects occur within 30 days after the procedure, while delayed side effects occur after 30 days and may include bruising, fever, nodule rupture, and nodule colliquation. Various measures can manage complications and alleviate discomfort or side effects, such as pain medications, ice packs, and voice rest. In rare cases, more serious complications like infection or bleeding may necessitate further medical intervention. Despite potential complications, numerous studies have demonstrated that RFA is a safe and effective treatment option for thyroid nodules, yielding excellent long-term results.