Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 11 2 2026 08 29 91 95 Elham Nazar Department of Pathology, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Seyed Amir Miratashi Yazdi Department of General Surgery, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Elahe Farmani Department of Pathology, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Aysan Nozheh Department of Pathology, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2026 07 07 2026 07 19 Transient hypocalcemia after thyroidectomy happens despite watchful preservation of the parathyroid glands and their blood supplies during surgery. Thyroidectomy for Graves’ disease is accompanied by a higher risk of transient hypocalcemia than for benign thyroid disease, including goiter, and the reasons are still unclear. We report two patients with Graves’ disease and goiter with symptomatic hypocalcemia after total thyroidectomy. We report a 64-year-old woman with multinodular goiter and a 41-year-old Iranian woman with a history of Graves’ disease who presented with transient symptomatic hypocalcemia after total thyroidectomy with intact parathyroid glands on surgery. They had a longer hospitalization time than usual surgeries due to hypocalcemia. However, they had normocalcemia at 1-year follow-up after discharge. Severe hypocalcemia after thyroidectomy can have some related complications and may be life-threatening. Calcium supplementation before surgery is a simple choice of treatment for the reduced probability of symptomatic hypocalcemia after Graves’ disease or benign thyroid disease in high-risk patients. https://crcp.tums.ac.ir/index.php/crcp/article/view/1215 https://crcp.tums.ac.ir/index.php/crcp/article/download/1215/786