A review of the literature on lingual thyroid over the past 10 years shows that the entity is no longer a rare clinicopathologic finding. At least 25 cases have been reported. This paper will not review the literature or historical background of the subject. Recent articles by Springer,1 Waters, McCullough, and Thomas2 have done this. While offering nothing original in the use of radioacitve iodine or management of the lingual thyroid, it is suggested in this article that use of the scintigram in establishing the diagnosis influences the choice of therapy. Sodium radioiodide I131 in the follow-up of the previously treated lingual thyroid patient is of great value in tracing the clinical course, studying the metabolic state, and/or estimating residual glandular tissue in cases treated by surgery vs. radioactive iodine. Various surgical aspects and techniques used in the treatment of lingual thyroid have been presented extensively in