Background: The introduction of Video assisted neck surgery (VANS) technique for treatment of thyroid diseases was established by K.Shimizu in 1998.Since that time, the indications of this procedure  are expanding  as regarding  the size of the thyroid tumors and the type of thyroid pathology. Results: Twelve patients with small diffuse primary thyrotoxicosis underwent video-assisted thyroidectomy. The estimated thyroid weight of the study patients ranged from 18.2 to 57 with a mean of32.5 grams. Three ofthefirst seven patients had recurrent hyperthyroidism. This was due to poor visualization and subsequently inadequate excision of the thyroid lobe away from the   camera. A  modification  was   made  thereafter that  corrected this  defect. Conclusion: Video-assisted near total thyroidectomy for Graves' disease is considered to be safe, effective. It gives excellent cosmetic results.