A marked thyroid enlargement and upper airway compression is predominantly caused by benign diseases and can present as chronic dyspnea or as acute dyspnea requiring immediate intervention. We encountered a 48-year-old female, who presented to us with acute life threatening airway distress requiring emergency intubation. Emergency thyroidectomy was carried out to relieve tracheal compression. The patient was successfully extubated after surgery and did well without tracheostomy. Introduction Patients with multinodular goiter or related thyroid disorders can rarely present with acute airway distress due to tracheal deviation or compression. Many of these patients are associated with weakness in the tracheal wall (tracheomalacia) making treachostomy mandatory in the postoperative period. Case Summary A 48-year-old female presented to the emergency department with severe dyspnea and marked cyanosis. On examination, she was having a huge thyroid swelling which was present for the last 20 years (Fig.1).
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