The first report of an association between myasthenia gravis (MG) and the thymus gland was in 1901. Although the underlying mechanisms are uncertain, thymic abnormalities are clearly associated with MG. This review article summarises, from a historical point of view, our knowledge of these associations, and the surgical and medical treatment of MG, including symptom management, immunosuppression, intravenous immunoglobulin and plasmapheresis.