Thyroidectomy has traditionally been the standard of care treatment for any thyroid issue that could not be medically managed. However, thermal ablative techniques have been gaining traction globally, representing a paradigm shift in thyroid nodule management, notably benign thyroid nodules. Naturally, as the success and popularity of thermal ablation for benign thyroid nodules increase, clinicians have begun to expand thermal ablation to ablation of thyroid neoplams including autonomously functioning nodules, microcarcinomas and, more recently, indeterminate nodules. This chapter explores the potential unique challenges of thermal ablation of thyroid neoplasms, provides guidance on case selection, and reviews the different technical approaches necessary to maximize the efficacy and safety of ablation.