Objective: To compare and analyze the clinical efficacy of microwave ablation technology and traditional open surgery in the treatment of benign thyroid nodules, and to evaluate the impact of the two treatment methods on the stress response of patients" bodies.Methods: A prospective randomized controlled study design was adopted. From April 2023 to April 2025, a total of 80 patients with benign thyroid nodules were divided into two groups by random number table method: the observation group (40 cases) received ultrasound-guided microwave ablation treatment, and the control group (40 cases) received traditional open surgical resection treatment. Observe the stress index levels of the two groups 24 hours after the operation (detected by electrochemical method), and compare the effective treatment rate and the incidence of complications.Results: The effective rates of treatment in the two groups were close, P > 0.05; The stress indicators and the incidence of complications in the observation group were lower, P < 0.05.Conclusion: Microwave ablation has a comparable therapeutic effect to traditional resection, but microwave ablation can significantly reduce the risk of surgical stress response and complications.