Background: Thyroidectomy is one of the commonest endocrine surgical procedures being carried out throughout the globe. Patients with thyroid disorder and cardiomyopathy are difficult to manage as they may develop complications like difficult airway, thyroid storm, heart failure etc.  Restoration of euthyroid state is recommended to prevent thyroid storm.  Other goals of anesthetic management are directed towards prevention of myocardial depression, maintenance of euvolemia, stable hemodynamic and management of complications. Case Report: We present a case of 42 years old female having left sided neck swelling which was gradually progressive and associated with chest pain and fatigue with minimal exertion. Conclusion: Anesthetic management of thyroid surgery in dilated cardiomyopathy can be managed by formulating the good anesthetic goals and prompt diagnosis and management of complications.