Introduction <p>Myasthenia gravis is a neuromuscular autoimmune condition characterized by the presence of antibodies against acetylcholine receptors. It may present as a generalized disorder or remain limited to specific muscle groups. Myasthenia gravis can occur independently or alongside other autoimmune conditions, including Hashimoto’s thyroiditis and Graves’ disease. Although the co-occurrence of these disorders is recognized, it is an extremely rare clinical phenomenon.</p> Case presentation <p>A 20-year-old woman of Muganda ethnicity, with a 2-year history of Graves’ disease confirmed by thyroid scintigraphy, developed a myasthenic syndrome leading to acute respiratory failure. Her condition improved with the administration of Prostigmine. Further investigations, including electrophysiological studies and immunological tests, confirmed a diagnosis of myasthenia gravis. The patient demonstrated a positive response to medical therapy.</p> Conclusion <p>This case highlights the importance of recognizing the rare association between myasthenia gravis and Graves’ disease. Accurate diagnosis and effective treatment require a coordinated, multidisciplinary approach, particularly given the challenges posed by overlapping symptoms and the exacerbating effects of hyperthyroidism on myasthenia gravis.</p>