Objective To analyse the risk factors of hypoparathyroidism and hypocalcemia after total thyroidectomy. Methods Clinical data of patients who underwent total thyroidectomy in a tertiary care hospital from the southern part of India was collected retrospectively from January 2021 to May 2023. Multivariate logistic regression was used to analyse the risk factors associated with transient hypoparathyroidism and hypocalcemia separately. Results A total of 300 patients who underwent total thyroidectomy were enrolled. The median age of the study population was 41 years, and 70% were females. Histopathological examination showed 80.3% had thyroid cancer. The incidence of postoperative transient hypoparathyroidism was 26.7%, while postoperative transient hypocalcemia was 12.3%. Multivariate analysis showed that presence of hypothyroidism before surgery (OR 3.230,95%CI:1.368–7.624,p=0.007), performing central compartment neck dissection (CCND) (OR 2.196,95%CI:1.133-4.257,p=0.02) and parathyroid gland in surgical specimen (OR 5.547, 95%CI:3.065–10.036,p<0.0001) were independent predictors of postoperative transient hypoparathyroidism. Female gender (OR 2.689,95%CI:1.049-6.895,p= 0.039), presence of parathyroid in the surgical specimen (OR 1.067,95%CI:0.367-8.438,p=0.004) and performing CCND (OR 2.192,95%CI:0.990-4.850,p=0.05) were independent predictors of postoperative transient hypocalcemia. Conclusion Hypoparathyroidism and hypocalcemia after thyroid surgery are common, and most of them are transient. Independent predictors of hypoparathyroidism and hypocalcemia differs. Hypoparathyroidism appears to be a better predictor for patients who will develop postoperative hypocalcemia.