An enlarged thyroid gland does not necessarily require surgery; some cases do not require surgery and some do. Physiologic goiter can be treated without surgery and according to your doctor’s instructions. However, the following conditions should be treated with thyroid surgery. 1. If the enlarged thyroid gland presses on the esophagus, trachea or recurrent laryngeal nerve and causes symptoms such as difficulty in breathing, difficulty in swallowing and hoarseness, thyroid surgery is needed. 2. Enlarged thyroid gland extends to the back of the sternum to become a retrosternal goiter, which not only easily compresses the esophagus and trachea, but also compresses the veins in the neck. When symptoms such as facial swelling and bruising occur, timely thyroid surgery is needed. 3. When the goiter is so large that it affects daily work and life, timely surgical treatment is needed. 4. When considering the possibility of malignant changes in nodular goiter, timely thyroid surgery is needed. When a goiter occurs, it is recommended to go to the hospital immediately for examination to clarify the cause of the disease so as not to delay treatment.