The next-generation device for monitoring of laryngeal nerves during thyroid surgery has been recently developed and has become commercially available. NIM Vital™ (Medtronic Xomed, Inc., Jacksonville, FL, USA) incorporates advantages as enhanced stability and flexibility for both intermittent and continuous laryngeal nerve monitoring. The new NIM NerveTrend™ EMG makes possible to track the recurrent laryngeal nerve condition throughout a procedure, even with intermittent mode. During monitoring, color status bars provide visual information and associated tones, audible cues, facilitating to monitor nerve function and interpretation of EMG trends. This new mode for laryngeal nerve monitoring has been clinically validated versus the I-IONM in a randomized controlled trial showing benefit as a significant decrease of need for a staged thyroidectomy. This chapter aims to present how NerveTrend™ works, its specifications and advantages over I-IONM and C-IONM, and how to use it.