Multinodular goiter (MNG) is a common clinical problem. Though most goiters are benign and asymptomatic, they may cause concern when they create compressive symptoms, develop autonomous functioning nodules, or form suspicious nodules. Diagnostic evaluation should include clinical evaluation, laboratory tests, and consideration of additional evaluation and imaging when there exists suspicion of complicating factors or risk of malignancy In nontoxic NING suppression therapy or serial clinical exams are appropriate in an asymptomatic, nonsuspicious goiter. In toxic XING, treatment of the resulting thyrotoxicosis followed by radioiodine or surgery is indicated. When compressive symptoms, risk of malignancy, or cosmetic deformity develops, surgery may also be indicated.