Papillary carcinoma arising in thyroglossal cyst is rare and is usually detected on post-operative histopathology after routine Sistrunk operation. Further management is a matter of debate and the choice lies between regular follow up after Sistrunk operation or total thyroidectomy with or without radioiodine ablation and thyroxine suppression therapy. Here we present a case of papillary carcinoma of thyroglossal duct cyst in a 26 year old lady. Papillary carcinoma was detected after a routine Sistrunk operation was done for a seemingly innocuous thyroglossal cyst. A total thyroidectomy was carried one week later followed by hormone replacement therapy to suppress serum TSH levels.