Comparative analysis of different methods of multinodular goiter diagnosis identified priority of fine-needle aspiration biopsy with subsequent cytologic examination of each node. Organ preserving thyroid resection appeared to be adequate only in case of unilobar colloid proliferating goiter or follicular tumor including combined lesions. Proposed model of choice of endoscopic surgical approach allowed receiving better cosmetic results not sacrificing extent of surgery for different types of thyroid pathology.