Selective use of drains after thyroidectomy has been suggested in the literature. Although the safety of thyroidectomy without drains has been reviewed, there is little specific data available to identify the safety of thyroidectomy combined with central neck dissection (CND) without drains. This study aims to determine the feasibility and safety of thyroidectomy without drains, especially in cases of combined CND. Prospective, randomized study. One hundred ninety-eight consecutive thyroidectomized patients were enrolled in this study. Drain group (n = 101) consisted of 41 hemithyroidectomies (HT), 28 total thyroidectomies (TT), and 32 total TT with CND. No-drain group (n = 97) consisted of 42 HT, 18 TT, and 37 TT with CND. The following variables were examined: perioperative complications (hemorrhage, hematoma, seroma), intraoperative bleeding, operation time, volume of resected thyroid gland, time of hospital discharge after operation, duration of drain placement, and total amount of drainage (drain group). There were no significant differences in age, sex, volume of resected thyroid gland, types of operation, operation time, and histopathlologic diagnosis between two groups. In the drain group, overall perioperative complications occurred in seven (7/101, 6.9%) patients. In the no-drain group, overall perioperative complications occurred in nine (10/97, 10.3%) patients. There was no significant difference in overall perioperative complications between the drain and no-drain groups, even in cases of performing CND. Time of hospital discharge after operation was significantly shorter in the no-drain group than the drain group (P < .05). We conclude that thyroidectomy without drains is safe and effective even in combination with CND and appears to confer several advantages over the routine drainage method. In addition, we achieved significant reduction of hospital stay, which led to a reduction in costs for the patients.