Objective:To investigate the perioperative management of refractory hyperthyroidism, and how to decrease severe postoperative complications in these patients.Methods :The clinical data of 21 patients whose medical treatment was ineffective or could not control preoperative thyroid heperfunction were analyzed retrospectively, and perioperative management was studied.Results:Among the 21 patients, 13 patients required large doses of antithyroid drugs and other drugs because the symptoms were serious and they received Lugol's solution for at least 2 weeks after the thyroid function was controlled to normal. Eight patients had to discontinue antithyroid drug medication because of the adverse drug effects and thus their thyroid function was not controlled to normal, they were given Lugol′s solution for 2-3 weeks even though their T3 and T4 levels were abnormal and then changed to compound iodine solution by continuous I V drip for 3-5 days before the operation. All the patients underwent bilateral subtotal thyroidectomy and were discharged without complications.Conclusions:For the patients whose thyroid function can not be controlled to normal, compound iodine given by continuons intravenous drip is an effective perioperative management. Individualized perioperative management and, timely treatment of early signs of postoperative hyperthyroidism are the key to success of operation.