In recent years, total thyroidectomy has become increasingly popular in the treatment of bilateral multinodular non-toxic goiter (MNG), replacing subtotal thyroidectomy in many high-volume endocrine surgery units worldwide [1, 2]. Nevertheless, the major benefits of total thyroidectomy understood as the risk of recurrent goiter reduced to almost zero and abolished need for revision thyroid surgery in the future should be balanced against the risk of postoperative morbidity. Thus, total thyroidectomy for benign thyroid disease continues to remain controversial, as there are many conflicting data published in the literature regarding the risk of hypoparathyroidism and recurrent laryngeal nerve injury stratified to indications for surgery, extent of thyroid resection and surgical volume [2–5]. Cirocchi et al.  published recently a Cochrane systematic review focused on total and near-total thyroidectomy versus subtotal thyroidectomy for MNG in adults and identified only four randomized controlled trials (RCT) in the field. Despite the fact that goiter recurrence was found to be reduced following total thyroidectomy (TT), the effects on other major endpoints, such as the need for revision surgery for goiter recurrence, prevalence of adverse events, and thyroid cancer incidence, remained unclear. Hence, new RCTs with a long-term follow-up and with additional focus on data such as surgical experience, surgical volume, and more attention to surgical technique were found to be needed . To fulfill this gap in evidence with more data, it was decided at our institution to continue follow-up of all consenting patients previously included into RCT for 5 years . Thus, the aim of this study was to validate in a 10-year follow-up the outcomes of RCT run at our institution and published in 2010 comparing results of various thyroid resection modes hitherto assessed within 5 years following surgery . The hypothesis explored at the present study was that the prevalence of recurrent goiter and need for revision thyroidectomy would increase with time of follow-up and that the cumulative risk of postoperative and post-revision morbidity of more limited thyroid resection modes would overweight the initial risk of total thyroidectomy.