Over the past 2 decades, use of thermal ablation for the treatment of benign symptomatic thyroid nodules has gained momentum worldwide as a valid and effective non-surgical treatment option for benign nodular disease that is endorsed and supported by all major international Thyroid Associations and Societies. Many patients prefer ablation to surgery as it preserves normal thyroid tissue and does not result in them needing hormonal replacement post treatment. However, although patients may view ablation as the only option for them, careful patient selection for these treatments is critical to optimise safety and post-procedural outcomes. Indications for ablation have now extended into the malignant realm of thyroid disease. The primary objective of this lecture is to provide an update on current indications and uses for thermal ablation in benign thyroid disease, including basic technical factors and long term outcomes. Application to non-benign disease will also be discussed.