Introduction: To enter the thyroid gland, the lateral "backdoor" technique (LA) uses the same central neck incision as the anterior border of the sternocleidomastoid (SCM) and strap muscles. Typically, this treatment is done to redo thyroid surgery. The results of the two procedures were compared in people who were having their first conventional thyroidectomy. Methods: A case-control study was undertaken on 30 people who received a routine open thyroidectomy from January 1, 2018 to December 31, 2019. The first 15 patients were given MA, then another 15 were given LA. All patients received 10 mL of 1 percent Marcaine infiltration before the neck incision was closed. Basic demographic data, surgery time, incision length, gland weight, strap muscle transection required, and complications were all recorded. The study excluded thyroid revision surgery and minimally invasive thyroid surgery. Results: Demographics, surgery time, gland weight, and incisional length did not differ significantly. The LA group experienced significantly reduced post-operative pain. 5 patients (11%) in the MA group required horizontal transection of strap muscles to remove large goitres, compared to 1 patient (2.2%) in the LA group. In neither group, there were any major issues. Conclusion: The LA approach is equally safe as the midline surgery, with a similar surgical time and substantially lower pain levels. By avoiding midline separation and suturing of strap muscles, it reduces the need for strap muscle transection to remove large goitres.