Thyroid surgery in recent years is generally considered quite safe. Better preoperative preparation and proper surgical techniques of thyroidectomy have minimized complications to less than 2-3%. Bilateral recurrent nerve palsy is the rarest of all complications, with a reported incidence varying between 0.4% to 14 %, but can be potentially fatal if missed [1, 2]. We report a case in which the patient experienced life threatening stridor and severe dyspnoea requiring re-intubation few minutes after extubation.