Background: Graves’ disease (GD) is the leading cause of hyperthyroidism, managed through medical or surgical means. Surgery is indicated for suspected malignancy, intolerance to antithyroid drugs, treatment failure and orbitopathy. Risks of total thyroidectomy for GD are well documented; these include permanent recurrent laryngeal nerve (RLN) injury (up to 2%), hematoma (about 1%), and hypocalcaemia (0.3% to 2% permanently, 15.5% temporarily). GD patients are particularly at risk of developing postoperative hypocalcaemia. Method: We conducted a retrospective review of GD patients undergoing thyroidectomy from 2005 to 2024 in Western Australia, analysing demographics and outcomes. Primary outcomes included complication rates (hematoma, RLN injury, hypocalcaemia), with secondary outcomes examining correlations between specimen weight and these complications Result: A total of 1,525 patients were identified, with 253 (16%) experiencing complications. 36 patients (2.3%) had a postoperative hematoma, 5 (0.3%) suffered permanent RLN injury, 32 (2%) experienced temporary RLN injury, 8 (0.5%) had permanent hypocalcaemia, and 102 (6.6%) showed temporary hypocalcaemia. Statistical analysis indicated that higher specimen weight weakly correlated with lower postoperative calcium (P=0.0013) and higher hematoma rates (p=0.0292). Female sex was identified as a significant risk factor for hypocalcaemia, with 10.1% of female patients showing postoperative hypocalcaemia vs. 4.2% of male patients (p=0,0267). Conclusion Our study showed good post-operative outcomes in line with literature. Higher specimen weight correlated with higher rates of hypocalcaemia and hematoma. Female sex was also a risk factor for hypocalcaemia.