Systematic compartmental clearance of regional lymph nodes is crucial in obtaining long term control of metastatic differentiated carcinoma of the thyroid gland in regional lymph nodes. This video demonstrates systematic and comprehensive clearance of regional lymph nodes from levels II thru V, in the lateral neck of a patient with metastatic papillary carcinoma of the thyroid gland. The fundamental principle of monobloc excision of all regional lymph nodes in the anterior as well as the posterior triangle of the neck is vividly demonstrated, protecting and preserving all non lymphatic and neurovascular structures. Considerations in the placement of the incisions and drainage tubes are also shown . Meticulous dissection in blood less manner with an electrocautery is demonstrated.