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Purpose: To determine whether postoperative radioiodine (RAI) combined with radiofrequency ablation (RFA) is an effective, safe, and feasible method for elimination of excessive postsurgical thyroid remnant for differentiated thyroid carcinoma (DTC). Materials and Methods: We took a prospective study and treated 12 DTC patients (4 males, 8 females, age 20-78 years) who underwent thyroidectomy for RFA followed by 131I ablation. The pretreatment requires iodine‑free diet and thyroid hormone withdrawal for 3-4 week. All the patients showed the level of serum thyroid‑stimulating hormone (TSH) <30 mU/L, and obvious thyroid remnant in 99mTechnetium (99mTc) imaging. Serum TSH level was determined 1 day before RFA and on days 1, 7, 14 after RFA, and 99mTc imaging was performed on day 14 after RFA. Subsequently, the patients were given an oral dosage of 3700 MBq 131I for remnant ablation, and posttreatment whole body scan was performed on day 5 after ablation. Efficacy evaluation was done 4-6 months after treatment. The changes of variants before and after RFA were analyzed using Wilcoxon signed rank sum test. Results: Serum TSH was <30 μIU/ml (mean value 10.27 ± 6.16 μIU/ml) before RFA, and increased to more than 30 μIU/ml (34.73 ± 3.93 μIU/ml) 2 weeks later (P = 0.002, Wilcoxon rank sum test). The 99mTc uptake ratio on day 14 postRFA was (0.31 ± 0.12)%, which is significantly lower than before RFA (0.80 ± 0.16)% (P = 0.002, Wilcoxon rank sum test). The success rate of thyroid remnant ablation was 91.7% (11/12), which was assessed 4-6 months after treatment. All patients reported neck discomfort and some are self‑limiting, with no hoarseness, choking, or radiation thyroiditis symptoms. Five patients had puncture area pain, among which one patient had neck edema, which was relieved after prednisone treatment. Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re‑operation. Long‑term efficacy monitoring would further determine its feasibility. [ABSTRACT FROM AUTHOR]