In the past 5 years (1987-1991), we admitted for thyroid surgery 12 patients older than 80 years. Indications for surgery were represented by goiter causing tracheal compression and severe dyspnoea in 6 cases, and by preoperative cytological report of malignancy in the other 6 cases. The dyspnoea represented an absolute surgical indication. All patients but one were treated by cervicotomy; in one case we performed a median sternotomy. Frozen section was performed in all patients with cytological report of malignancy. Histology detected 3 differentiated cancers, 2 anaplastic cancers, and one follicular adenoma. The patients with benign disease were treated by 4 subtotal thyroidectomies and 3 total lobectomies. Three out of 5 affected by malignant lesions were submitted to a total thyroidectomy (differentiated carcinomas) and 2 to palliative thyroidectomy (anaplastic carcinoma). In this series there were neither intraoperative mortality nor major surgical complications. All the patients with dyspnoea were cured by surgery. All the patients affected by differentiated cancer were alive and well 8, 13 and 18 months after surgery. The mean survival of patients with anaplastic cancer was 12 months.