Lingual thyroid is a rare congenital anomaly, resulting from maldescent of thyroid tissue during embryonic development. Here we describe a case with lingual thyroid and subclinical hypothyroidism. Suppressive therapy with L-Thyroxine resulted with an uneventful one-year follow-up period.In view of the clinical course of this patient and review of the literature, we conclude that, suppressive therapy with L-Thyroxine should be preferred to surgical therapy initially in patients with asymptomatic lingual thyroid.