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Thyroid storm is most commonly caused by underlying Grave's disease, a solitary toxic nodule or toxic thyroid goiter. Although hypothyroidism is a recognised complication of head and neck cancer treatment [3,4], thyrotoxicosis is rare. To date there are no reported cases in literature of thyroid storm following head and neck surgery. We report a case of thyroid storm following a laryngopharyngoesophagectomy with gastric pullup for laryngeal cancer in a previously euthyroid patient without known thyroid disease. We discuss the patient's journey, make recommendations in preventing and then addressing this rare complication postoperatively, should it occur.