To evaluate the safety, feasibility and cosmetic results of endoscopic thyroidectomy via improved breast areola approach for male patients with thyroid tumor. From April 2012 to September 2014, 38 male patients with thyroid tumor underwent endoscopic thyroidectomy at our institution. Among all the patients, postoperative diagnosis included 5 cases with nodular hyperplasia, 2 cases of colloid lesion within a nodular goiter, 8 cases of follicular adenoma and 23 cases of micropapillary thyroid carcinoma. The endoscopic thyroidectomy was completed successfully in all patients. The types of endoscopic procedures were 10 cases with lobectomies, 5 cases with subtotal thyroidectomy, 21 cases with thyroidectomy with ipsilateral central compartment dissection, and 2 cases with total thyroidectomy with bilateral ipsilateral central compartment dissection. The average tumor size was 1.39 ± 1.01 cm (range 0.3-3.5 cm), and the average operating time was 128.1 ± 25.8 cm (range 65-195 cm) minutes. The postoperative drainage volume was 124.1 ± 41.7 ml (range 50-200 ml), and the average length of the hospital stay was 5.29 ± 0.92 days (range 4-8 days). There were no patients developed to hypercapnia. Postoperative complications included transient RLN palsy in 2 cases, transient hypocalcemia in 1 case, swallowing discomfort in 1 case and paresthesia of the chest in 3 cases. Endoscopic thyroidectomy via improved breast areola approach in male patients with thyroid tumor is safe and feasible, it can successfully treat bilateral thyroid diseases, and give an excellent cosmetic result. It might become the procedure of choice for male patients who want the best cosmetic results.