After a rigorous clinical screening and diagnosis of Hashimoto encephalopathy (HE), consideration should be given to how to develop a standardized treatment plan. HE is considered a hormone-sensitive encephalopathy, and corticosteroids remain the drug of choice for HE today, with proven efficacy. The treatment usually involves intravenous methylprednisolone 1000mg/d shock therapy, followed by oral prednisone 60-80mg/d after 5d. The symptoms usually resolve within 1-6 weeks, after which the dosage is gradually reduced according to the condition, and the general hormone maintenance period is not less than 6 months. While applying hormones for a long time, it is necessary to pay attention to the side effects brought by hormones. Common side effects include hyperglycemia, hypertension, peptic ulcer, osteoporosis, femoral head necrosis, centripetal obesity, easy infection, electrolyte disorders, etc. Therefore, calcium supplementation, potassium supplementation, protection of gastric mucosa and monitoring of liver and kidney function, blood picture and other indicators should be given accordingly. For a few patients with HE who are resistant to corticosteroids or cannot tolerate the side effects of hormones, intermittent intravenous immunoglobulin (IVIg) or plasma exchange are also effective treatment measures. Immunosuppressive drugs such as azathioprine, methotrexate and cyclophosphamide should be given as early as possible to patients with a significant tendency to relapse or who have a poor outcome on first treatment.