Objective To observe the effect of tracheal catheter monitored by the recurrent laryngeal nerve on postoperative sore throat (POST) after endoscopic thyroid surgery. Methods A total of 116 patients, American Society of Anesthesiologists (ASA) grades Ⅰ or Ⅱ, aged 18‒65 years old, who underwent endoscopic thyroid surgery at the First Affiliated Hospital of University of Science and Technology of China from January 2022 to December 2022, were selected. According to the random number table method, they were divided into two groups (n=58): a recurrent laryngeal nerve‑monitored tracheal catheter group (group N) and a commonly reinforced tracheal catheter group (group R). The recurrent laryngeal nerve‑monitored tracheal catheter was used in group N, and commonly reinforced tracheal catheter was used in group R, while other anesthetic methods were the same. The sore throat Visual Analogue Scale (VAS) scores at resting and during swallowing at post‑extubation 0.5 h, 6.0 h and 24.0 h were recorded. The incidence of adverse reactions (POST, hoarseness, cough, choking and dyspnea), and remedial analgesia within 24 h after extubation were recorded in both groups. Results Compared with group R, group N showed increases in the incidence of POST (P<0.05) and decreases in the incidence of hoarseness and choking (all P<0.05) within postoperative 24 h, and increases in rescue analgesia use (P<0.05). Compared with group R, group N showed increases in sore throat VAS scores at resting and during swallowing at post‑extubation 0.5 h and 6.0 h (all P<0.05). There was no significant difference in other indexes between the two groups (all P>0.05). Conclusions Tracheal catheter monitored by the recurrent laryngeal nerve can be applied in endoscopic thyroid surgery, which reduces the incidence of postoperative hoarseness and choking, with increases in the incidence of POST and the degree of pain compared with common tracheal catheter.