This study presents an analytic review about the trait of the thyroid foramen. A detailed description about the demographics, frequency, embryology, morphometry, possible content, topography, clinical and surgical considerations is provided. The overall frequency was 28.3% in adults, 15% in children and neonates, 40.6% in embryos and fetuses. The content of the thyroid foramina was a neurovascular bundle in 41.2% of studies. An equal number of studies define a nerve as the common content, while only in 17.6% the usual content was a vessel. Interestingly, in 11.8% the content was just connective tissue or a pit. An updated classification is presented taking into account all the possible content that can cross through a thyroid foramen. The variant is of high interest for surgeons intervening in the larynx due to potential complications such as local bleeding and unwanted neural impairment. The oblique line of the thyroid lamina acts as the best topographical landmark to identify any aberrant anatomy related to a thyroid foramen. Clin. Anat. 26:700-708, 2013. © 2013 Wiley Periodicals, Inc.