Background: Thyroid cancer is the most common endocrine carcinoma, as it accounts for almost 90% of all endocrine malignancies. The incidence of thyroid carcinoma is about 1-3 cases in every 100,000 population. During the last 30 years, the rate of thyroid cancer incidence has increased worldwide. Objective: The aim of this work was to determine the frequency of thyroid carcinoma in multinodular goiter in patients undergoing thyroidectomy to make a strategy to perform total thyroidectomy (TT) as a rule of treatment. Patients and methods: This retrospective study included the medical charts and surgical data of a total of 50 patients who underwent surgery for goiter at General Surgery Department, Aswan University Hospital between 2015 and 2018. Results: The present study showed that the frequency of papillary carcinoma was 6% of all thyroid diseases (from 50 patients), 60% of incidental thyroid carcinoma as the frequency was high in the 4th decade of life. The present study showed that the frequency of follicular carcinoma was 2% of all thyroid diseases (one case), 20% of ITC. Patient was in the 4th decade. The present study showed that the frequency of undifferentiated thyroid cancer was 2% of all thyroid diseases. Conclusion: It could be concluded that, according to the finding of this study, total thyroidectomy is the preferred method in benign thyroid disease for which surgery is indicated. The advantages of TT include reduction of recurrence rate, achieves a permanent cure of thyroid disorders.