Background: There is still debate over the use of regional anesthesia during thyroid surgeries. Objective: This investigation looked at the effectiveness of an ultrasound-guided bilateral superficial cervical plexus block (BSCPB) combined with a tolerable endotracheal tube (TET) for reducing hemodynamic stress response and respiratory issues as well as controlling pain during and after surgery. Methods: This prospective randomized controlled comparative clinical research was performed at the Department of Anesthesia, Surgical Critical Care and Pain Control in Zagazig University Hospitals. Patients were split into two groups: Group I (Control group, "C") where patients received general anesthesia with classic endotracheal tube (ETT) and systemic analgesia. Group II ("BSCPB+TET" "B") patients got ultrasound guided BSCPB then general anesthesia with TET. Results: Postoperative cough, bronchospasm, and sore throat were substantially distinct between the tested groups statistically. Group B had significantly less cough than group C. None of patients in group B had postoperative bronchospasm compared to 22.22% of patients in group C. Group B had significantly lower sore throat than group C Conclusions: The use of BSCPB with TET in thyroid surgeries can achieve intraoperative hemodynamic stability, increase time for 1^st analgesic request, decrease total dose of intraoperative and postoperative analgesic requirements and reduce the frequency of postoperative difficulties in patients undergoing elective thyroid surgeries.