The cases of 387 patients who had 407 operations for thyroid disease between 1958 and 1982 at a university-affiliated city-county hospital were evaluated to assess the morbidity and mortality associated with thyroid operation. A mortality of 0.7% was found, owing to coexisting systemic disease, advanced patient age, and delayed treatment. Recurrent laryngeal nerve damage was rare (0.6%). Permanent hypoparathyroidism appeared in 0.9%, probably related to disrupted blood supply rather than tissue removal. Of those patients who had subtotal thyroidectomy and follow-up of six years or more, 15.8% had hypothyroidism, a rate substantially lower than that following radioactive iodine ablation for Graves' disease. This study indicates that operative procedures on the thyroid can be done with acceptable morbidity and mortality.