ObjectiveTo evaluate the safety and efficacy of lenvatinib as targeted therapy for locally advanced thyroid cancer. MethodsThe data of patients with locally advanced thyroid cancer including details on therapy dosage, treatment outcomes and drug-related adverse events who received targeted therapy in the Department of Head and Neck Surgery, Clinical Oncology School of Fujian Medical University from September 2021 to June 2023 were collected and analyzed. ResultsSeventeen patients received lenvatinib for a median of 8 weeks (range, 4–32 weeks). The objective response and disease control rates were 29.4% (5/17) and 94.1% (16/17) respectively. Five patients did not undergo surgery because of tumor progression and their refusal; R0/1 resection was achieved in eleven of the twelve remaining patients (91.7%). The commonest drug-related adverse events were hypertension (7/17, 41.2%), diarrhea (6/17, 35.3%), and proteinuria (5/17, 29.4%). There were no major treatment-related adverse events. ConclusionPreliminary analysis indicates that lenvatinib is effective and safe for targeted therapy of locally advanced thyroid cancer, with a relatively high rate of R0/1 resection.