Until recently, definitive treatment for most thyroid nodules was restricted to partial or total thyroidectomy, radioiodine therapy, or suppressive levothyroxine therapy, all of which have potential drawbacks. On the other side of the spectrum stands observational follow-up, which despite avoiding procedural complications, may lead to compressive symptoms or cosmetic concerns. In this context, Radiofrequency Ablation (RFA) and other thermal therapies have emerged to fill in the gap of less invasive and yet similarly effective therapeutic options for neoplastic thyroid disease. In the past ten years, RFA, for many reasons, has been progressively more employed in the treatment of thyroid nodules than other thermal treatments. This minimally invasive technique is mainly beneficial in the face of patients who reject or are unsuitable for surgery due to clinical or cosmetic reasons. Many publications have already established RFA’s efficacy on large benign nodules or papillary microcarcinomas, confirming its role as a feasible alternative to thyroidectomy or radioiodine therapy. Moreover, complications such as thyroidectomy or radioiodine-induced hypothyroidism are significantly milder or less common in patients submitted to RFA. Besides this, its use in treating parathyroid adenomas and lymph node metastasis of thyroid cancer has been reported. This special issue aims to update the recent trends in this innovative and disruptive technique concerning the treatment of benign and malignant thyroid nodules, thyroid neck metastasis, and parathyroid adenomas and discuss new applications and perspectives.