Thyroid disorders in the general population are common, and many of these patients may require nonthyroidal surgery. This chapter focuses on the perioperative management of these patients with newly diagnosed or poorly controlled hypo- or hyperthyroidism, in the setting of either elective or urgent surgery. Generally, those with subclinical thyroid dysfunction can proceed with surgery with little or no intervention. However, the patient with overt hyper- and hypothyroidism should ideally be rendered euthyroid prior to surgery. In severe thyroid disease where the surgical risk is the highest, a multimodal approach with medical and airway management, along with close hemodynamic monitoring, is necessary for those who must undergo urgent surgery.