The prevalence of thyroid diseases in the elderly differs from the younger population due to anatomical and functional changes with advancing age. In this chapter, imaging features of common thyroid diseases including thyrotoxicosis, hypothyroidism, thyroid nodules, and thyroid carcinomas are discussed. Imaging approach and imaging findings of thyroid diseases in the elderly are not different from other age groups. Imaging plays an important role in the detection of structural abnormalities, helps diagnosis, and guides management in the elderly, especially those who may have subtle clinical presentations.