KQ 14.1. Unexpected tracheal injury during thyroid surgery usually occurs because of an unexpected tracheal invasion of the thyroid. Tracheal injury is classified as partial- or full-layer injury according to thickness, window, or segmental injury by circumference. Partial-layer injuries do not usually require surgical management. Full-layer injuries can be managed with primary closure or tracheal fenestration. Circumferential injuries usually require end-to-end anastomosis of the trachea. KQ 14.2. Unexpected esophageal injury during thyroid surgery usually occurs after resection of the esophageal invasion of thyroid cancer. Most frequently, esophageal invasion involves only the muscularis layer and spares the mucosa and submucosa. Thus, intraluminal injury of the esophagus is rarely encountered. However, if a full-thickness defect occurs, primary closure with tension-free multilayer sutures can often be achieved if the surrounding tissue is healthy. In the case of extensive and circumferential full-thickness injury, reconstruction using microvascular-free tissue transfer should be considered. KQ 14.3–14.5. The primary role of the thyroid gland involves regulating the body’s metabolism through the secretion of thyroid hormones. Given its unique anatomical placement and physiological function, it is imperative to administer suitable surgical treatment in such circumstances related to thyroid disease, along with implementing systematic postoperative management to prevent complications.