Protecting the recurrent laryngeal nerve (RLN) and superior laryngeal nerve during thyroid and parathyroid surgery remains a significant challenge. Traditional methods primarily rely on visual identification and regional protection techniques to minimize nerve injury. However, these approaches often face challenges such as limited working space, high procedural difficulty, and incomplete tissue removal. Intraoperative nerve monitoring uses neuro physiological techniques to assess the functional integrity of nerves, aiming to prevent or reduce nerve damage. Intraoperative nerve monitoring for laryngeal nerve protection during thyroid and parathyroid surgery provides an effective means of evaluating RLN damage. For successful RLN monitoring, both monitoring personnel and surgeons need a solid understanding of nerve monitoring principles, follow of standardized surgical procedures, and be able to troubleshoot abnormal signals during surgery. With ongoing advancements in technology, nerve monitoring devices are expected to become more sensitive, offering rapid and precise waveform analysis, and en hancing user-friendliness. Additionally, minimally invasive thyroidectomy and robot-assisted surgical systems hold promising potential for the future of thyroid surgery. This paper reviews the use of Intraoperative nerve monitoring and RLN monitoring, incorporating the latest research from both domestic and international studies. It discusses the importance of RLN monitoring, the principles of monitoring technologies, current research on RLN monitoring technology, guidelines for nerve monitoring, and strategies for managing and analyzing abnormal monitoring signals.