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Background and Objectives:The main indication for thyroidectomy are thyroid cancer, multinodular goiter, and Graves disease. Most important complications of thyroidectomy are recurent laryngeal nerve injury and hypoparathyroidism. The risk of com-plication depends on the extent of the operation, and skill and experiences of surgeon. The purpose of this study is to determine the incidence and predictive factors for complication after thyroidectomy. Materials and Method:We examined the records of 233 patients who underwent thyroidectomy at the Department of Otolaryngology, Hanyang University from 1994 to 2001. The The rate of recurent laryngeal nerve palsy was calculated on the number of nerve at risk of injury. There were 135 unilateral and 98 bilateral procedures. Nerves at risk is 329. The hypocalcemia was defined as a ionized calcium fell below 1.01 mEq/L. Results:Among 233 patients, 3 patients (1.3%) had permanent hypocalcemia and 57 patients (24.5%) had transient hypocal-cemia. According to surgical procedure total thyroidectomy with neck dissection was associated with an increased risk of transient hypocalcemia (63.6%) (3/329) and 0.3% (1/329), respectively. The postoperative hematoma occured in 7 patients (3% ). Conclusion:The most frequent complication after thyroidectomy is transient hypocalcemia. Based on our results, thyroidectomy is a relatively safe procedure. Complications can be kept to a minimum by a through knowledge of the anatomy, by understanding thyroid pathology, and by meticulous he-mostasis and delicate surgical technique.(Korean J Otolaryngol 202 ;45 :1092-7)