Given the widespread iodine deficiency, diffuse and diffuse nodular euthyroid goiter is an urgent problem. A large goiter needs to be highlighted both from the perspective of possible complications for the patient, including a decrease in the quality of life and compression syndrome, as well as from the perspective of the complexity of surgical treatment, given the technical complexity of the operation and the high probability of intraoperative and postoperative complications. The article describes a clinical case of a patient admitted to the endocrinology department with a diagnosis of diffuse nodular goiter of the 2nd degree for examination with complaints of a huge deforming formation of the neck contours, difficulty breathing when walking and during sleep. It is known from the anamnesis that the patient has been observed for about 10 years by an endocrinologist with nodular goiter. The patient was repeatedly offered surgical treatment, which he categorically refused. In the Department of endocrinology, the patient underwent a comprehensive examination to assess the condition and function of the thyroid gland, as well as to identify possible complications.