Ablative techniques for thyroid nodules offer an alternative to surgery in patients with benign symptomatic nodules and may be considered in select cases of autonomous functioning nodules or thyroid malignancy. In the selection of a thyroid nodule for treatment with ablation, patient factors as well as nodule characteristics and resource availability should be considered. Ablative techniques are not equally suited for all nodules and therefore the merits and limitations of different ablative techniques, such as radiofrequency ablation, ethanol ablation, laser ablation, microwave ablation, and high intensity focused ultrasound, should be thought of in the context of patient and nodule factors as well as clinician experience and skill. This chapter provides a comprehensive review of thermal ablation for carefully selected nodules within the appropriate clinical context, taking into consideration the goals of care and the availability of resources and expertise.