Objective: To explore the effects of modified ipsilateral tracheal approach (MIA) and microwave ablation (MA) on body trauma in benign thyroid nodules. Methods: A total of 90 patients with benign thyroid nodules admitted to the hospital were enrolled as the research objects between January 2021 and March 2023. According to random number table method, they were divided into control group (traditional ipsilateral tracheal approach + MA, n=45) and observation group (MIA + MA, n=45). The differences in MA relevant indexes, clinical indexes and safety indexes between the two groups were compared. Results: The usage of spacer fluid in observation group was higher than that in control group, and ablation time was shorter than that in control group (P<0.05). The clinical indexes (operation time, intraoperative blood loss, length of hospital stay) in observation group were lower than those in control group (P<0.05). The incidence of postoperative adverse reactions in observation group was lower than that in control group (66.67% vs 86.67%), and incidence of postoperative permanent laryngeal nerve injury, transient hoarseness, pain and neck swelling was also lower than that in control group (P<0.05). Conclusion: For patients with benign thyroid nodules, MIA has high usage of spacer fluid, short operation time and length of hospital stay, little intraoperative blood loss and high safety.