In this research, we used a technique for the identification of recurrent laryngeal nerves (RLN) and the parathyroid gland intraoperatively, by spraying methylene blue dye in the tracheoesophageal groove area, following ligation of the superior pole during the thyroid dissection. This technique is supposed to be an adjuvant method for the RLN and parathyroid glands identification. In order to correctly detect and preserve the parathyroid glands and RLN during complete thyroidectomy, the goal of this research was to assess the usefulness of utilizing methylene blue spray throughout surgery to minimize post-operative complications. Methods: This was a Comparative prospective randomized controlled cohort study by simple randomization (envelope) that consisted of 30 Egyptian individuals of either gender, aged 18-60 years old presenting with benign thyroid disorders requiring total thyroidectomy. The participants were divided into two distinct categories: group 1 had 15 instances that required surgical intervention using intraoperative methylene blue spray and group 2 included 15 cases to be operated with the conventional technique. Results: There was a non-statistically substantial variation among the groups under study as regard total Ca, Ionized Ca 1 day and 1 month postoperative of the studied patients. Timing started after the skin incision to the end of the operation. The mean thyroidectomy duration in the non-MB group was 91.33±7.98 min, while it was 114.73±6.79min with MB application with a statistically substantial variation. Hospital stays among studied groups ranged from one to three days (1.43 ± 0.73), during which time patients underwent clinical assessments, calcium level monitoring, and treatment for hypocalcemia with the non-statistically substantial variation among the groups under study. Conclusions: Methylene blue spray could be used during thyroidectomy to correctly identify the parathyroid glands and RLN to reduce the incidence of complications. The use of intraoperative methylene blue spraying is thought to be a secure, affordable, and accessible technique that can lessen the anxiety associated with thyroidectomy dissection.