Posterior mediastinal goiter extending to carotid sheath posteriorly is rare repoted case. Recently we experienced huge posterior mediastinal goiter with compressin of trachea in 57-year old male, The patient that complained of dyspnea referred to our hospital for further evaluation of mediasitnal tumor. We confirmed huge secondary posterior mediastinal intrathoracic goiter with diagnostic methods following by chest X-ray, thyroid scan, chest CT, and CT guided fine needle aspiration biopsy in this patient, and performed operation for excision Exision of posterior mediasitnal goiter performed through initial transeverse cervical incision and additional median sternotomy, and the mass removed completely without any complications. The postoperative course were uneventful.