There has been increasing interest in same-day surgery, and the proportion of outpatient thyroidectomies has been increasing over time. Same-day thyroidectomy has been shown to be safe in selected patients. However, the practice is highly controversial with practice guidelines espousing opposing views published by two influential endocrine societies. In addition, patient selection has always been considered fundamental for safe same-day endocrine surgery, but there is no consensus on what the specific selection criteria are. In addition, patient selection criteria for same-day thyroidectomy, postoperative observation periods, and protocols differ across institutions and among surgeons who practice same-day surgery. Same-day thyroidectomies are most often performed at high-volume, specialized centers and implementing new same-day endocrine surgery pathways should be done cautiously.