Ectopic thyroid tissue refers to presence of thyroid tissue at locations away from the normal site in the pretracheal region in the lower neck. Few of such cases are associated with a functioning thyroid gland in its normal anatomical location. However in many cases, the ectopic thyroid gland is the only functioning thyroid. Radionuclide scan is mandatory when dealing with an ectopic thyroid lesion. A colloid goiter in such a case may be large enough to cause cosmetic disfigurement, but still may be functioning. Patient will be deprived of a functioning thyroid tissue, if such a case is treated surgically, necessitating thyroid hormone supplementation for the rest of patient’s life.