Injury to the recurrent laryngeal nerve is the most common and serious complication after thyroid surgery. Many different techniques have been described in the literature and interest in intraoperative neuromonitoring (IONM) has increased in an effort to prevent adverse events. IONM implicated for identification of the nerve and evaluation of its function during the operation. Continuous IONM was recently introduced and looks promising for early recognition and safe operation in the end. This paper describes the role of IONM, and its current and future issues.