Background:Substernal goiter is defined as a thyroid mass of which more than half is located below the thoracic inlet. Most of substernal goiters can be removed via cervical incision. But where the malignant-looking nodule appears adherent to mediastinal structures on CT or MRI scan, posterior mediastinal spread, massive size with goiter extending inferior to the aortic arch, and ectopic goiter located deep in the mediastinum can be required combined cervical and partial sternotomy approach. We report a case of huge goiter extending to right main bronchus who underwent total thyroidectomy via cervical incision. Patients:A 71-year-old woman visited hospital due to progressive dyspnea.Chest CT and neck CT showed huge goiter extending to the aortic arch compressed trachea to left side. Total thyroidectomy underwent throuth the neck, without upper sternotomy.She was recovered well and dyspnea disappeared. Conclusion & summary:Commonly, huge goiter extending to deep space of mediastinum was used to be excised by cervicothoracic incision. But we present one case who had huge goiter extending to right main bronchus underwent operation by cervical incision successfully.