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Current head and neck squamous cell carcinoma (HNSCC) treatment pathways involve combinations of surgery, radiotherapy and chemotherapy. Traditional radical surgery involves open procedures requiring jaw splits and wide visible incisions. These procedures carry high associated morbidity and postoperative quality of life outcomes are poor.

We present a rare case of a 31-year-old patient with Graves’ disease with agenesis of the left thyroid lobe. The patient was managed with a right hemithyroidectomy and isthmusectomy as definitively treatment of Graves’ disease. The patient had an uneventful postoperative outcome and the histology was benign and consistent with Graves’ disease. This is a rare case in the literature of Graves’ disease with unilateral thyroid agenesis, and to our knowledge is the first reported case from the UK.