Objective: To explore the clinical application value of the transareolar approach and the oral vestibular approach in radical surgery for differentiated thyroid carcinoma (DTC), with a focus on evaluating their safety and efficacy in terms of the completeness of lymph node dissection, and the protection of the parathyroid glands and recurrent laryngeal nerves. Methods: A retrospective analysis was conducted on the clinical data of 13 DTC patients who underwent endoscopic radical thyroidectomy via the transareolar approach combined with the oral vestibular approach at Loudi Central Hospital between October 2021 and June 2024. The analyzed indicators included operative time, intraoperative blood loss, number of lymph nodes dissected, postoperative complications, and cosmetic satisfaction. All data were statistically analyzed using SPSS 22.0 software. Results: All surgeries were successfully completed without conversion to open surgery. The mean operative time was (251 ± 66.7) min, intraoperative blood loss was (19.6 ± 11.3) ml, and postoperative hospital stay was (6.2 ± 1.1) days. Adequate lymph node dissection was achieved in both the central and lateral neck compartments. Minor postoperative complications occurred, including transient hypocalcemia (2 cases), hoarseness (2 cases), and chylous fistula (1 case), all of which resolved within 3 months postoperatively. Overall cosmetic satisfaction was high, and no recurrence or metastasis was observed during short-term follow-up in any patient. Conclusion: The transareolar approach combined with the oral vestibular approach demonstrates good safety and effective dissection in radical surgery for differentiated thyroid carcinoma, with few postoperative complications and excellent cosmetic outcomes. It can be considered as one of the promising endoscopic surgical techniques worthy of promotion.