Abstract: Objective To study the factors for success excision of huge goiter. Methods Twenty-eight patients with huge goiter admitted to our department from February 2006 to September 2011 were included in this study.They underwent total thyroidectomy or subtotal resection and were followed up for more than one year. Results The huge goiter was successfully removed in all patients.The operation time was 60-120 min (mean 85 min) with an intra-operative blood loss of 20-60 ml.Of these patients, 4 underwent tracheal suspension surgery and 3 underwent tracheotomy, during which temporary recurrent laryngeal nerve paralysis occurred in 2 and lip numbness in 2.Their hospital stay time was 5-14 days (mean 7 days).Biopsy showed nodular goiter accompanying micropapillary carcinoma in 4 patients after operation. Conclusion Good exposure, rich anatomy knowledge, careful operation mode, meticulous tissue discrimination, and rational procedure are the key factors for successful excision of huge goiter.