Introduction: the authors review their experience about treatment of occult thyroid carcinoma. Patients and methods: 24 patients with papillary occult carcinoma of the thyroid were observed in the period 1999-2001. All carcinoma was 10 mm in diameter. In seventeen patients (71%) was performed a total thyroidectomy, while in seven (29%) a lobectomy; in four of seven patients treated with lobectomy was subsequently performed a total thyroidectomy. Total thyroidectomy wasn’t performed in three female patients aged <35 years, with a 5 mm -diameter carcinoma. In two patients (8,3%) with nodal metastasis a lymph node excision was perfomed. All patients were alive and free of disease at last control. Conclusions: the incidental finding of occult thyroid carcinoma in a patient treated with a lobectomy does not entail a subsequent total thyroidectomy, because of this surgical procedure may be oncologically correct; therefore the authors believe that total thyroidectomy may be the treatment of choice of occult carcinoma, because it allows a correct oncological follow-up.