A case of granular cell tumor of the thyroid gland occurring in a 23-year-old woman is reported. The patient presented with a painless mass in the neck, but was otherwise in good health and had no associated disorders. Fine-needle aspiration biopsy was performed prior to surgery and yielded thyroid epithelial cells with possible oncocytic-type change. To our knowledge, the English language literature contains only one other report of a granular cell tumor of the thyroid. Our case supports the recent suggestion of a neural crest origin for some types of thyroid neoplasia.