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Introduction: The surgical approach of substernal goiter (BM) can be challenging, and may cause significant complication rate. Objective: Comparing data from the thyroidectomies for substernal goiter of DCCP-HCFMUSP with a non-substernal goiter equivalent group. The emphasis will be on pre and post-operative complications. Methods: A retrospective case control study of thyroidectomy occurred between 2010 and 2014. The surgeries information was collected from a spreadsheet. The patients were divided into two groups: Group 1 (case), counting with fifty-two operations for BM; and Group 2 (control), composed of sixtyone thyroidectomies for non-substernal goiter surgeries. Data of both groups were compared by means of a statistical study. Clinical criteria were used to define substernal goiter. Results: Patients with substernal goiter had higher rates of signs of laryngopharyngeal reflux on preoperative laryngoscopy (41.5% vs. 20.5%, p = 0.036 - chi-square test), and more voluminous goiters on preoperative ultrasonography. It was noted that operations for substernal goiter was an average of 23 minutes longer (p = 0.049 - Student t test) and had a tendency to longer hospital staying (two days vs. 2.4 days, p = 0.079 - Student t test) compared to thyroidectomy for non-substernal goiter. Other complications presented no differences between groups. Conclusion: In DCCPHCFMUSP, thyroidectomies for substernal and non-substernal goiters complication rates are similar. The occurrence of reflux laryngitis diagnosed in preoperative laryngoscopy is higher in patients with substernal goiter, and statistical data reinforce the relationship between substernal goiter and reflux. [ABSTRACT FROM AUTHOR]