In the last 10 years 20 patients with Hürthle tumors were observed at Institute of Surgery and Oncology of Cagliari University. 17 were females and 3 males with a median age of 42 years. Tumors were malignant in 7 cases and benign in 13. A total thyroidectomy was performed in all patients with carcinoma and in 2 with adenoma because of concurrent goiter. The remaining patients were treated with a less extensive surgery. Two patients with carcinoma had a cervical node metastases at 12 and 67 months, treated by surgery (followed by radioiodine therapy in one). All patients are alive and disease free at 72 months of median follow-up. None of patients with benign adenomas recurred at 47 months of median follow-up. A longer-term follow-up is necessary in order to evaluate the benignity of adenomas.