Objective To explore the effects of ultrasound‑guided bilateral cervical nerve pathway block on the postoperative quality of recovery in patients undergoing thyroid surgery. Methods This study was a prospective, double‑blind, randomized controlled trial. According to the random number table method, 60 patients undergoing partial resection of the thyroid under general anesthesia were divided into the following group (n=30): an experimental group and a control group. After anesthesia induction, patients in the two groups underwent ultrasound‑guided bilateral cervical nerve pathway block and bilateral superficial cervical plexus block, respectively. The primary outcome was the quality of recovery 24 h after surgery [assessed by 40‑item Quality of Recovery Score (QoR‑40)]. The secondary outcomes included the consumption of propofol and remifentanil, endoscopist satisfaction, changes in heart rate and mean arterial pressure (MAP) when patients become stable in the operation room (T1), 2 min after block (T2), and immediately after skin incision (T3), awakening time, adverse reactions during the recovery period, the length of postanesthesia care unit (PACU) stay, and the scores of Numerical Rating Scale (NRS) 0, 4, 8 h and 24 h after surgery at resting and during movement (coughing). Results The experimental group showed significant increases in QoR‑40 score 24 h after operation, compared with the control group (P<0.05), especially in the self‑care ability and pain dimension (P<0.05). Compared with the control group, the experimental group presented decreases in the consumption of remifentanil during anesthesia maintenance, increases in endoscopist satisfaction (VAS score), decreases in heart rate and MAP at T1, T2 and T3, decreases in awakening time, and decreases in NRS scores at resting 0, 4 h and 8 h after surgery (P<0.05). There was no statistical difference in the duration of surgery and anesthesia, the consumption of propofol, adverse reactions in the recovery period, and the length of PACU stay between the two groups (P>0.05). Conclusions Ultrasound‑guided bilateral cervical nerve pathway block in patients undergoing thyroid surgery is useful to improve the quality of recovery in the early postoperative period.