The presence of an ectopic thyroid at the base of the tongue (midline) is a rare embryological malformation in the descending process of the thyroid gland and is termed as Lingual thyroid. These aberrant thyroid tissue are commonly found in the base of the tongue and it is subjected to the same diseases as the thyroid gland. A 22-year-old male patient presented to our ward with the chief complaint of sore throat for three days duration with no other symptoms. On fiberoptic nasolarygoscopic examination (FNE) a well-defined, circumscribed swelling with a rich blood supply was detected at the posterior aspect of the tongue. Tc⁹⁹ᵐ scanning showed increased tracer activity was noted in the sublingual region suggestive of a Lingual thyroid with thyroiditis whilst thyroid function tests confirmed Hypothyroidism. The patient was treated conservatively with steroids and thyroxine. Surgery was not offered due to the lack of obstructive features. His symptoms have since improved and is followed up at our clinic.