Objective To explore the effect of targeted nursing in patients undergoing endoscopic thyroidectomy and its influence on aesthetic satisfaction. Methods A total of 66 patients who underwent endoscopic thyroidectomy in Department of General Surgery, Laixi People's Hospital from January 2022 to January 2023 were randomly divided into control group and observation group, with 33 patients in each group. The control group was given routine nursing, and the observation group was given targeted nursing. The negative emotions, scar conditions, scar attention, aesthetic satisfaction and recovery were compared between the two groups. Results After intervention, the SAS score and SDS score of the observation group were lower than those of the control group (P<0.05). The VSS score of the observation group was lower than those of the control group (P<0.05). The scar attention of the observation group was 96.67%, which was higher than 81.82% of the control group (P <0.05). The aesthetic satisfaction of the observation group was 96.67%, which was higher than 78.79% of the control group (P<0.05). The scores of emotional state, body comfort level, psychological support, self-care ability and pain in the observation group were higher than those in the control group (P<0.05). Conclusion Targeted nursing has a definite application effect in patients undergoing endoscopic thyroidectomy, which can improve scar attention, reduce scar conditions, improve patients' bad mood, improve aesthetic satisfaction, and promote patients' physical and mental health.