BACKGROUND:– The term ‘occult’ thyroid cancer is a term applied to a very small, unsuspected cancer identified incidentally on pathologic examination of thyroid tissue removed for benign disease. Aim of this study are to evaluate the incidence of occult thyroid carcinoma after thyroidectomy for benign thyroid lesions with its different pathological types. MATERIAL AND METHODS:– This observational study included 42 patients who were admitted and treated in the Department of General Surgery, Rajendra Institute of Medical Sciences, Ranchi with features of benign enlargement of thyroid gland, between January 2017 to October 2018 and fulfilled the inclusion criteria. RESULTS:– Most patients were females with mean age of 40.72 yrs. Mean age of occult carcinoma in patients was 44 yrs. The commonest presenting complaint was that of a swelling in front of neck with gradually increasing size. Majority of patients presented with a MNG. The incidence of occult thyroid carcinoma was 12% out of the total 42 patients. The incidence of occult malignancy was higher in multinodular goitre compared to others with no variation with factors like age or sex. Papillary carcinoma was the most common histopathological type. CONCLUSIONS:– Total thyroidectomy instead of hemithyroidectomy will help avoid recurrence for lesions that are multifocal or bilateral thyroid swelling. It also prevents the difficulties of second thyroidectomy due to adhesions and difficult anatomical dissection