Of 1294 patients examined with struma of magnitude I to III, complications in the form of mechanical effects on the neighboring organs, disturbances of thyroid function and pathological anatomical changes in the struma were demonstrated in 1051 cases. The appearance of high-seated esophageal varices is described in 33 patients with primary struma of magnitude II and III. 72 patients had congenital or postnatal hypothyroidism, and 164 patients a subclinical one. The carcinoma ratio (2.9%) was in the lower range of the normal for the endemic areas. Because of the high complication rate, every struma should be clarified diagnostically and specifically treated.