Introduction: Hypoparathyroidism (HPT) is one of the most frequent and severe complications of thyroid surgery. It is caused by intraoperative damage, devascularization or accidental removal of the parathyroid glands (PTG). The incidence of postoperative HPT is directly proportional to surgery extent and surgeon’s experience. However, it can be significantly reduced by excellent surgical technique. The authors present original technique of in situ preservation of PTGs during thyroid surgery and 40-years-experience results in postoperative HPT. Methods: Dzodics original surgical technique (personal PhD thesis, 1993; published in J BUON, 2017) focuses on meticulous capsular dissection and ligation of blood vessels close to thyroid capsule. The key step is preservation of the middle thyroid, Kocher’s, vein trunk, as well as vein branches that accompany posterior branch of superior thyroid artery and inferior thyroid artery trunk. The use of methylene blue dye for sentinel lymph nodes biopsy facilitates identification of PTGs during removal of thyroid gland, as well as central neck dissection (in case of thyroid carcinomas), since PTGs are not colored in blue, unlike central lymph nodes. Results: After 40 years of experience in thyroid surgery, and several thousands of preserved PTGs using Dzodics original surgical technique, a total prevalence of permanent HPT in the personal series is less than 0.5%. Conclusions: Dzodics original surgical technique of venous trunk’s preservation, along with so far known surgical steps for in situ preservation of PTGs on arterial pedicles, provides good outcome for patients after total thyroidectomy, with or without central neck dissection, regarding HPT as one of the most severe complications of thyroid surgery. We find methylene blue dye of great importance, not only for sentinel lymph nodes biopsy, but also for avoiding accidental removal of unrecognized PTGs.