Grave’s Disease (Diffuse toxic goiter of thyroid gland) is the commonest cause of hyperthyroidism in children especially between 11-15 years of age and has a female predilection. Patients present with motor hyperactivity, emotional lability, short attention span, tremors, voracious appetite with no increase in weight, exophthalmos, smooth flushed skin with excessive sweating, tachycardia, palpitations, cardiac enlargement and in long standing cases a goiter. Etiology is postulated to be failure of T suppressor cells which leads to increased T helper cells which activate B cells to form thyrotropin receptor stimulating antibody (TRS Ab) leading to stimulation of T3 & T4 secretion. Grave’s disease may be associated with conditions such as Type 1 Diabetes Mellitus, Addison’s disease, Vitiligo, Pernicious anemia, Alopecia areata, Myasthenia Gravis & Celiac disease. Laboratory investigations would reveal elevated serum levels of thyroxine (T4), triiodothyronine (T3), free T4 and free T3. Levels of TSH are suppressed. TRS Ab is positive which disappear on remission of the disease. Treatment consists of antithyroid drugs. (Methimazole is 10 times more potent than propylthiouracil (PTU) with longer serum half-life and can be given once daily). PTU is preferred in pregnant and lactating mother as it does not cross placenta or pass into breast milk. Antithyroid drugs can cause leucopoenia, urticarial rash, hepatitis, glomerulonephritis & lupus like reaction and thus have to be monitored for same. Drug therapy may be required for 5 years or longer. Beta-adrenergic blocking agent- propanolol is useful in severely toxic patients. Surgery or radioiodine treatment is indicated when Medical Management fails or severe side effects of antithyroid drugs occur. Radioiodine is a safe alternate therapy in children over 10 years of age.