Goitre, which is a generic term for thyroid enlargement, is common and thyroid malignancy rare, but the clinical presentations of benign and malignant thyroid disease are similar. The aim of clinical assessment and investigations is to identify the small number of cancers amongst non-malignant thyroid enlargements. Investigations include thyroid function tests and fine-needle aspiration cytology. Benign thyroid disease requires treatment only in the presence of dysfunction or local compressive symptoms. The treatment of thyroid cancer is multidisciplinary and includes surgery, radioiodine therapy and lifelong suppression of thyroid-stimulating hormone. The diagnosis and management of thyroid cancer are being centralized around a multidisciplinary team structure in order to improve outcomes in the UK.