Laser ablation is an image-guided interventional technique that has emerged in the 1990s as promising treatment for thyroid nodules. Since then, increasing evidence showed that this technique may effectively treat symptomatic benign thyroid nodules. Laser ablation is performed in an outpatient setting, is well tolerated, and in skilled hands carries a very low rate of mostly transient complications. Laser ablation has been demonstrated to be particularly effective in shrinking nonfunctioning, spongiform nodules with a volume less than 15 mL with a targeted energy delivery of 500 J/mL. Technique efficacy is achieved in 2/3 of nodules, and a volume reduction ratio by more than 50% can be obtained over the time. In autonomously functioning nodules, it is effective when used in small nodules, while in combination with radioactive treatment, it is effective also in large nodules.