POEMS syndrome, also known as Crow-Fukase syndrome, represents a rare multisystem syndrome characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. Hypothyroidism is one of the common endocrine abnormalities which are central features of POEMS syndrome. The clinical data associated with the measurement of thyroid function and its clinical significance in POEMS syndrome is still rare. Herein, we report 24 cases with POEMS syndrome which were studied thyroid function and clinical manifestations and performed an associated analysis between hypothyroidism and edema/effusions. Of the 24 patients with POEMS syndrome, 17(70.8%) had a recognized hypothyroidism (including 11 clinical hypothyroidism and 6 subclinical hypothyroidism). Fourteen patients (58.3%) had some form of extravascular volume overload. In 14 patients with edema/effusions, 12 were diagnosed as having hypothyroidism. Hypothyroidism may be one of causes of edema/effusions. After thyroid hormone treatment and chemotherapy, symptoms of hypothyroidism and edema /effusions were improved greatly.