BACKGROUND AND OBJECTIVES: To evaluate the efficacy and safety of early neck exercises to reduce post-thyroidectomy symptoms and syndromes for patients undergoing thyroid surgery. MATERIALS AND METHODS: One hundred patients who had undergone thyroid surgery were randomly assigned 1:1 to control (delayed exercise, initiating at postoperative 2 weeks) or early exercise group (initiating at postoperative 1 day). Questionnaire survey (voice, globus sense, neck discomfort, swallowing difficulty) and objective measurement (surgical wound adhesion, range of neck motion and scar scale) were performed at 2 weeks and 3 months postoperatively. RESULTS: Compared to control, early exercise significantly decreased the degree of neck discomfort at 2 weeks after thyroid surgery (p=0.037) while other subjective symptoms including voice change, globus sense, and swallowing difficulty were not significantly different between the two groups. The degree of surgical wound adhesion was significantly decreased (p<0.001) and the range of motion was improved in early exercise group (p=0.010). In addition, the objective scores of Vancouver Scar Scale (VSS) were decreased in early exercise group compared to those of control group (p=0.020). CONCLUSION: Early neck exercises are safe and effective to reduce postoperative neck discomfort, wound adhesion, or hypertrophy of scar and to improve the range of motion in patients undergoing thyroid surgery.