The incidence of Incidental Thyroid Carcinoma (ITC) ranges from 3 to 16% in different series. Detection of thyroid carcinomas in post–operative biopsy specimens operated for benign thyroid disorders required second surgery, increasing the risk of complications. A retrospective review of 159 patients operated for benign thyroid diseases was done, after excluding the patients with pre–operative diagnosis of malignancy or suspicion of malignancy. Out of 159 patients, ITC was detected in 14 specimens (8.8%) of which 10 were papillary, 2 follicular, 1 medullary and 1 non–Hodgkin’s lymphoma. No correlation of incidence ITC in relation to age, sex, pre–operative diagnosis and thyroid function was observed. Half of these patients required re–surgery exposing the patients to high complication rate compared to total thyroidectomy as initial procedure of choice. This suggests total thyroidectomy would be a valuable choice for patients operated for nodular thyroid diseases, though controversy exists.