Abstract Background Autonomously functioning thyroid nodules (AFTNs) constitute 5-7% of thyroid nodules and represent the second most common cause of hyperthyroidism following Graves’ Disease. Currently, radioactive iodine (RAI) and surgery are the standard treatment options, and both incur a risk of post-procedural hypothyroidism and other surgery and radiation- related complications. Methods This work aimed at assessing the efficacy of RFA, as an alternative treatment option, in resolving hyperthyroidism and also assess the nodule volume rate reduction (VRR) and its associated adverse events. Results A total of 22 patients underwent RFA for a solitary AFTN. 72% (n=16) had subclinical hyperthyroidism, 9% (n=2) had overt hyperthyroidism, and 18% (n=4) were biochemically euthyroid on anti-thyroid medication (ATD). Average pre-treatment TSH was 0.41 mIU/L (SD= 0.98) and free T4 1.29 ng/dl (SD= 0.33). Following a single RFA session, hyperthyroidism resolved in 90.9% (n= 20) and average VRR (61.13%) was achieved within 3-6 months following the ablation. Except for one nodule, none of the nodules grew during the follow-up period (16.5 months). Two patients (9%) developed transient tachycardia requiring short-term beta-blocker therapy, and two developed mild hypothyroidism requiring levothyroxine therapy. Two patients developed recurrent hyperthyroidism and elected to undergo lobectomy and repeat RFA respectively. No serious adverse effects were noted in this cohort. Conclusions RAI and/or surgery represent the standard of care for toxic adenomas but RFA shows excellent efficacy and safety profile. Therefore, at centers with RFA expertise it should be considered an alternative treatment strategy, avoiding radiation and surgery-related complications.