Pituitary lesions can occur as a consequence of primary hypothyroidism and the biochemical imbalance associated with it, making its diagnosis a challenging task necessitating a thorough patient assessment by the treating physicians. We describe a young patient with pituitary hyperplasia due to primary hypothyroidism who presented with complaints of menstrual irregularities and weight gain. The patient was treated with thyroxine (T4) for primary hypothyroidism. The patient reported improvement in her symptoms along with the normalization of thyroid profile and interval reduction in the size of pituitary lesion on follow-up MRI scan.