Decreased thyroid hormone synthesis and low levels of circulating thyroid hormones result in biochemical and/or clinical hypothyroidism. Deficiency of thyroid hormones causes many metabolic processes to slow down. The maintenance of optimal health requires an adequate supply of carbohydrates, proteins and lipids, and macronutrients, micronutrients, and trace elements. In this work, the serum content of the trace elements; Zn, Cu, Mn, and Se in hypothyroidism patients was determined and compared to that of normal subjects. Seventy three ypothyroid patients and fifty normal healthy control persons participated in this study. Serum zinc and copper were determined using flame atomic absorption spectrophotometer, while determination of manganese and selenium were done using flameless atomic absorption spectrophotometer. The results showed that serum zinc and selenium level of hypothyroidism patients are significantly lower (p<0.05) than the level in normal subjects. A significant increase in serum manganese level was demonstrated in patients as compared with that of the normal subjects while there is no significant difference between the groups (p>0.05) in serum copper. The results of this work as discussed indicate, the role of these trace elements in many metabolic process either as essential nutrients or as cofactors for different enzymes contributed directly or indirectly to the hypothyroidism. Consequently, the results of this study suggest that the metabolism of zinc, manganese, and selenium is abnormal in hypothyroidism disease.