This review aims to explore the potency of fluorescence-image guided surgery to prevent both complications. This review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Medline, Scopus, and CENTRAL databases were used to identify abstracts using predefined search terms. Two independent reviewers reviewed the abstracts and were selected according to inclusion and exclusion criteria. Risk of bias in non-randomized studies - of intervention tool was applied to reduce any potential of bias in included studies. The mean and standard deviation of 1-day after the surgery of parathyroid hormone (PTH) and serum calcium level were extracted. Any potential heterogeneity was evaluated with I2. Seven articles were included in this review. The meta-analysis showed that a total thyroidectomy with fluorescence has significantly higher PTH levels than the control group (g = 0.29; 95%CI = 0.02 – 0.57). In the subgroup analysis, ICG arm had a significant contribution for maintaining the PTH level post-operatively (g = 0.48; 95%CI = 0.24 – 0.72) while NIRAF did not (g = 0.04; 95%CI = -0.18 – 0.26). In both subgroups, the heterogeneity was negligible (I2 = 0%; P = 0.52). The analysis of serum calcium level reported that the FIGS group has a higher serum calcium level in comparison with the control group and it was significant (g = 0.48; 95%CI = 0.29 – 0.66). The heterogeneity was low and not significant (I2 = 19%; P = 0.29). FIGS has showed its usefulness for preventing two major endocrine complication following thyroidectomy.