A three year old hyperactive female child presented with a midline neck swelling of one year duration. Clinical examination revealed a nodule in the isthmus of thyroid. Her Thyroid Stimulating Hormone (TSH) was suppressed and Free T3 and Free T4 levels were elevated. Radionuclide scintigraphy showed a hyperfunctioning nodule in the isthmus of thyroid. Patient was administered antithyroid medication and brought to euthyroid state. Isthmectomy was done. Post-operative period was uneventful. Patient was discharged on third post-operative day and is on regular follow up.