Background and aims: Retrosternal goiter (RG) is defined as a thyroid mass of which more than 50% is located below the thoracic inlet. It can give rise to various compression symptoms like dyspnea and dysphagia, which necessitate the need for surgery. The aim of this study is to review the management of patients with retrosternal extension of goiter through a neck collar incision without sternotomy with minimal morbidity at a tertiary care center. Materials and methods: A retrospective analysis of 224 patients who underwent thyroid surgery between January 2014 and August 2018, in Department of ENT in RajaRajeswari Medical College and Hospital, Bengaluru, Karnataka, was done. Total 21 patients had retrosternal extension of thyroid. The patients were evaluated with respect to their demographics, clinical symptoms, thyroid gland location, histopathological results, and postoperative complications. Results: The median age was 51 years with range from 30 to 72 years. The ratio of thyroidectomies due to RG with respect to all thyroidectomies in this study population was 9.37%. All the patients underwent thyroidectomy (hemi/total) through cervical approach without sternotomy. The most common presentation was neck swelling (76.19%) followed by neck discomfort (23.80%) and dyspnea (9.52%). The final histopathological diagnosis in most of the patients was benign (80.95 %). Temporary postoperative complications occurred in five patients, which later resolved with treatment. Conclusion: Majority of RG are benign but surgery should always be considered because of risk of symptoms related to compression, acute airway obstruction, and the possible risk of malignancy. Clinical significance: Most of the RG can be adequately resected via cervical collar incision without sternotomy with minimal morbidity.