Background: Grave's disease is an autoimmune disease caused by thyroid receptor antibodies that 
activate the thyrotrophin receptor, leading to stimulation of cyclic adenosine monophosphate 
synthesis and production of thyroid hormones in the follicular cells. The prevelance of GD is 0.5% of 
the population and is the underlying aetiology for 50-80% of cases of hyperthyroidism. Objective: To 
compare total vs modified subtotal thyroidectomy in the management of Graves' disease as regards 
control of the disease, incidence of recurrence and postoperative complications. Patients and 
Methods: Our study was conducted on 40 patients suffering from GD that had been recruited from 
the out-patient clinic of surgical department of Al-Azhar Assuit University Hospital. 20 cases have 
total thyroidectomy and the other 20 have had modified subtotal thyroidectomy. Inclusion criteria was 
the age from 20 to 60 years (males or females) and failed medical treatment for 6 months. Patients 
excluded were those less than 20 years old, exophthalmous, chronic debilitating disease, malignancy, 
and any patient with preoperative vocal cord affection. Results: The range of pre-operative thyroid 
profile shows T3 level 9.4+/-2, T4 level 6.1+/-2 while TSH level 0.08+/-0.02 in total thyroidectomy 
group and T3 level 8.9+/-2, T4 level 5.5+/-21.6 while TSH level 0.09+/-0.01in modified subtotal 
group. This study showed no significant changes in both groups as regards postoperative hospital stay. 
In our study showed that hyocalcemia is the most common immediate post operative complication.