Revision cervical endocrine surgery increases risks for injury to important adjacent structures, possibly resulting in hoarseness and postoperative hypocalcemia. With anatomic knowledge and appropriate use of meticulous dissection techniques, the surgeon strives to minimize morbidity. Technologic advances have provided tools to aid in these difficult cases and maintain the thoroughness of resection while reducing morbidity. The judicious use of preoperative imaging can assist the surgeon in identifying the precise location of disease, thus reducing unnecessary dissection and risk to surrounding structures, while still performing complete resections.