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Pericardial effusion is a rare complication of Graves’ disease. A pregnant Filipino woman with diffuse goiter and hyperthyroid symptoms was initially treated as a case of Graves’ disease. She was readmitted for exertional dyspnea, orthopnea, and bipedal edema; an echocardiogram revealed a massive pericardial effusion. Workup for other causes of the effusion was unremarkable. The pericardial effusion resolved after pericardiostomy and anti-thyroid medications. This highlights the clinician’s role in determining the association between the two disease entities.