Thyroidectomy is one of the possible therapeutic options in Graves' disease as are antithyroid drugs and (131)radioiodine. Emerging data reveal an advantage of total thyroidal ablation as the method of choice in patients with impending or overt Graves' orbitopathy. Pros and cons are discussed as presented at the 1st Swiss Symposium on Thyroid Eye Disease in Pontresina, Switzerland in December 2007.