In the era of minimally invasive surgery, thyroid nodules and thyroid cancer are being managed with new approaches. Lobectomy is indicated for selected tumors, radio frequency ablation may be an option for benign nodules and scarless surgery for either benign or malignant disease. Even active surveillance is accepted for very selected patients with malignant disease. How to select patients for each kind of treatment? We will discuss the global perspectives of actual management of thyroid nodules and cancer, specially in United States and Brazil, representing different scenarios.