Multifocal fibrosclerosis, as the name implies, concerns disseminated fibrous processes that manifest as Riedel’s thyroiditis, idiopathic retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, and pseudotumor of the orbit. Certain cases of fibrosis of the parotid gland, the lacrimal glands, and the lung may belong in the same category. The cases of two patients with Riedel’s thyroiditis, one of whom also had retroperitoneal fibrosis, are described. Unusual changes in the small and middle-sized veins in the fibrous tissue in the thyroid and in the retroperitoneum, best designated “occlusive phlebitis,” seem to be characteristic of the multifocal fibrosclerosis. They may contribute to the disease process.