Retrosternal enlargement of the thyroid can cause compression of several mediastinal structures. Tracheal obstruction and superior vena cava syndrome are rare complications of retrosternal goiter. We report a 60 old-year woman, complaining of hard dyspnea and with oedema of the face and the neck. She was treated for hyperthyroidism but not regurlarly. Alongside with other many examinations she had an ultrasonography of thyroid gland. The result was a giant thyroid with heterogeneous nodules, with necrotic area, in its both lobes and compressing phenomena over trachea and jugular vein. This thyroid extended to the superior mediastinum, until the tracheal bifurcation, an image confirmed by thoracic computed tomography. Thyroid needle aspiration biopsy didn't give any data for atypism and malignance. The patient had surgical intervention, total thyroidectomy. Histological examination confirmed multinodular goiter. One month after surgery, the patient had total remission of compressive signs and now, she feels well and is taking hormone replacement therapy regularly.