Purpose Radiofrequency ablation (RFA) is a novel minimally invasive treatment for symptomatic thyroid nodules. Although RFA is well established in some international centres, its application is not yet widespread in Australasia. We describe the implementation of a RFA program in a tertiary hospital endocrine surgery service and treatment related outcomes. Methodology A prospective case series of patients treated with ultrasound-guided RFA for benign symptomatic thyroid nodules between May 2024 and October 2025 was undertaken. Follow-up occurred at 3, 6 and 12 months post-RFA. The primary outcome measure was nodule volume reduction rate (VRR). Secondary outcome measures were compressive symptom and cosmetic scores. Results 10 patients were enrolled in a prospective study. All patients had compressive symptoms and/or cosmetic concerns. One patient underwent RFA of two hyperfunctioning nodules. The median energy delivered per nodule was 0.400kCal (IQR -0.083-0.883kCal) Median follow-up was 6 months. The median nodule volume reduced from 8.12mL at baseline to 1.58mL at 3 months post-RFA (p<0.001). The median volume reduction rate (VRR) was 61.8%, 63.2% and 88.3% (IQR 75.1-101.5%) at 3,6 and 12 months respectively post-RFA. Therapeutic success (VRR>50%) was achieved in 7 out of 11 (63.6%) of nodules by 6 months. The median compressive symptom score reduced from 6/60 at baseline to 1/60 at 3 month follow-up (p=0.013) with no significant subsequent change. The median cosmetic score improved from 3.5/4 at baseline to 2/4 at 3-month follow-up (p=0.001). No patient experienced complications or regrowth. The patient with hyperfunctioning nodules was able to cease carbimazole and all other patients remained euthyroid. Conclusion Thyroid nodule RFA can achieve significant reduction in nodule volume and improvement in compressive symptoms. This novel treatment can be safely introduced into an established Endocrine Surgical program.