Thyroid cancer is generally associated with a good prognosis, yet mortality in the UK was reported to be higher than other developed countries, and published audits have highlighted deficiencies in management of this condition in Scotland and England. The British Thyroid Association (BTA) responded by publishing national guidelines for the management of differentiated thyroid cancer in 2002. Since then, other guidelines and consensus statements have been published from Europe and America. The BTA has recently updated its guidelines in the light of new advances and new directives from government relating to cancer waiting times. Robust evidence from randomised controlled trials on the treatment of differentiated thyroid cancer is still lacking, however there is general consensus that patients who are in a high risk category, should be treated with total or near-total thyroidectomy, radioiodine ablation and long-term suppressive thyroxine therapy. The management of low or intermediate risk patients remains controversial. Although the new guidelines differ in detail from each other and from earlier publications, they share the principle of tailoring the management plan in the light of available evidence and the individual characteristics of the patient.