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Abstract Background Patient decision aids (PDAs) are interventions that support patients and clinicians in complex decision-making by providing detailed information and clarifying personal values. This study developed and validated two thyroid cancer PDAs in determining the extent of surgical resection for low-risk differentiated thyroid cancer (DTC). Method Following a structured process proposed by the International Patient Decision Aids Standards, the PDAs were built based on available systematic reviews, meta-analyses, and patients’ informational needs during treatment decision-making. The comprehensibility, acceptability, and desirability of the PDAs were assessed iteratively through focus groups, online surveys and think-aloud usability testing with thyroid cancer patients, members of the public and thyroid clinicians. Results The PDAs were created as 10-page booklets consisting of six sections: ‘Key information’, ‘Treatment option’, ‘Compare your options’, ‘What matters most to you’, ‘Further information', and ‘Patient support’. Information was displayed using a range of visual illustrations, including decision trees, pictograms, comparison charts, and Likert scales. The focus group discussion (n = 10 patients/members of the public) and online survey (n = 21 clinicians) showed that the PDAs were comprehensive, engaging, and balanced. The result of the think-aloud usability testing (n = 10 patients/members of the public) proved that the PDAs were easy to use for decision-making and appropriate for people with low literacy and numeracy skills. Conclusion We have developed and validated the UK’s first PDA to support low-risk DTC patients in deciding the extent of their primary surgery. They can facilitate shared decision-making by providing a reliable, unbiased, and comprehensible representation of clinical options and outcomes tailored to patients’ needs.