Pretibial myxedema, which consists of localized cutaneous accumulations of acid mucopolyeaccharides, occurs in a small percentage of patients with diffuse toxic goiter. Pretibial myxedema may also occur during the course of nonthyrotoxic thyroid disease. A case of pretibial myxedema with diffuse toxic goiter in 64 year-old female is reported. She has been suffered from thickened yellowish waxy pIaques on both pretibial areas and left dorsum of foot. Initial skin lesions developed about 7 months ago, and increased its size and numbers insidiously. Diagnosis was confirmed by characteristic clinical, laboratory and histopathological findings. Literatures were reviewed.