Great neck disease is another name for an enlarged thyroid gland, which usually appears as a thickening of the neck, hence the name “great neck disease”. It is most common in the early years of liberation and occurs mostly in poor and remote areas. It is mostly endemic goiter, a hyperplastic enlargement of the thyroid gland caused by iodine deficiency. The mechanism of goiter is unknown, but it is generally believed to be related to the following factors 1. Iodine deficiency: Generally, in high altitude and remote areas of the plateau, iodine intake is insufficient due to the loss of iodine in the soil by rainwater washing and insufficient iodine content in drinking water and diet. 2. Disorders of thyroid synthesis or secretion: (1) Excessive iodine intake, such as hyperiodogenic goiter. (2) Goitre-causing substances and drugs: such as thioureas. (3) Congenital thyroid synthesis disorders: Defects in certain enzymes affect the synthesis and secretion of thyroid hormones. (3) During puberty, pregnancy and lactation, the body’s need for thyroid hormones increases, which can lead to physiological goiter due to relative iodine deficiency. ”It is generally believed that one or more of the above factors hinder the synthesis and secretion of thyroid hormones, resulting in an increase in thyrotropic secretion, thus causing compensatory hypertrophy of the thyroid gland. It can be treated with iodine supplementation and thyroid preparations, and surgery can be considered for those with symptoms of pressure and ineffective medication.