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Background: Fine-needle aspiration biopsy can very reliably discriminate between benign and malignant thyroid tumors. The role of additional intraoperative frozen section to guide intraoperative management was questioned.Methods: A retrospective analysis of all thyroid resections at our department between 2000 and 2004 was performed.Results: 420 patients with benign thyroid lesions underwent surgical resections. 169 lobectomies and 251 total thyroidectomies were performed and 57 (13.5 %) thyroid cancers discovered (mostly papillary carcinomas). 54 frozen sections were performed and sensitivity rate of 11.1 % and specificity rate of 97.8 % was estimated.Conclusions: Our data supports the fact that intraoperative frozen section is not sensitive enough to substantially add to preoperative fine-needle aspiration biopsy, even with more selective use. We conclude that routine use of frozen section is not cost-effective in surgery of the benign thyroid and can therefore be abandoned.