This chapter examines the outcomes of total thyroidectomy (TT) versus thyroid lobectomy (TL) in pediatric patients with low-risk papillary thyroid carcinoma (PTC), focusing on survival measures (disease-free and overall survival), and treatment-associated complications. Drawing on small- and large-scale studies on the subject matter, the chapter presents evidence demonstrating that both TT and TL offer comparable overall and recurrence-free survival rates in low-risk pediatric PTC patients. However, TL may confer a lower risk of surgical complications, highlighting the importance of individualized treatment decisions based on a balanced risk-benefit analyses. This chapter also highlights the need for further prospective studies to refine surgical guidelines and supports a more conservative approach in selected cases, aimed at optimizing long-term patient health and quality of life.