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Objectives/Hypothesis Recent American Thyroid Association Guidelines recommend either near‐total/total thyroidectomy or lobectomy for patients with a thyroid nodule suspicious for papillary thyroid cancer (PTC) on fine‐needle aspiration (FNA) biopsy (Bethesda V). In this analysis, we aim to assess the cost‐effectiveness of lobectomy in comparison to total thyroidectomy. Study Design Cost‐effectiveness analysis. Methods A Markov model cost‐effectiveness analysis was performed for a base case followed for 20 years postoperatively. Cost and probabilities data were retrieved from the current literature. Effectiveness was represented by quality‐adjusted life year (QALY). Results Total thyroidectomy protocol produced an incremental cost of 2,681.36andincrementaleffectivenessof−0.24QALYascomparedtolobectomyprotocol(incrementalcost‐effectivenessratioICER=− 11,188.85/QALY). Sensitivity analysis …