Purpose Radiofrequency ablation (RFA) is an internationally well-established minimally invasive procedure used to treat both benign and malignant thyroid nodules. It is not widely offered yet in Australia, due in part to a lack of Medicare rebate. Long-term follow-up has shown RFA to be safe and effective with a reduced complication profile compared to surgery however its economic feasibility within Australia has not yet been analysed. This review aims to provide a cost analysis of RFA compared to hemithyroidectomy in Australia. Methodology Patient journey and care cycles were modelled for hemithyroidectomy and RFA based on the treatment of a single symptomatic thyroid nodule in an otherwise well patient in a public hospital with a focus on inpatient operational costs. Variable direct costs (VDCs), staffing requirements and pathological examination costs were defined and compared for both procedures. Results For a hemithyroidectomy, the overall cost was $4219.75 compared to $2373.09 for RFA (56% less). Consumable costs for hemithyroidectomy totalled $1913.60 compared to $2233.58 for RFA. Other costings including histopathological analysis of a thyroid lobe compared to preoperative cytological assessment of fine-needle aspirate (FNA) biopsy were also included. Treatment with RFA would result in a saving of $1846.66 per thyroid nodule treated, with the outlay costs of the RFA machine recuperated after 20 nodule ablations. Sensitivity analysis of a 20% increase in RFA costs over base case found RFA remained cost saving of $1372.04. Conclusion In Australia’s resource constrained health system, cost-effectiveness as well as clinical efficacy is necessary for the uptake of new procedures. This analysis demonstrates cost feasibility for the use of RFA compared to hemithyroidectomy in an Australian public hospital for treatment of a symptomatic benign thyroid nodule.